1

Jurado

Graves’ Disease
An Uncured Auto Immune Disease
2
Jurado

Cynthia Jurado

Professor Sgobba

Introduction to Special Education 203

17 November 2021

Graves’ Disease

You may feel irritable, anxious, restless, or have trouble sleeping. Have brain fog,

unintended weight loss, abnormal heat intolerance, muscle weakness, fatigue, or protrusion, or

bulging eyeballs from their sockets. You may also notice a bulging in the throat or feel you

cannot clear your throat, these are thyroid nodules. Going to the doctor with a list of ailments

may get you a diagnosis of an uncured auto-immune disease. “A very common medical

condition, Hyperthyroidism is often undiagnosed and, when diagnosed, is often under-treated.

(Horwitz)”

“Graves’ Hyperthyroidism is an auto-immune condition that arises because of the loss of

immunological tolerance to the thyroid-stimulating hormone receptor. (Lane 1)” It has been

around, uncured, for nearly 140 years. The first description of thyroid diseases as they are known

today was Graves’ disease by Caleb Parry in 1786, but the pathogenesis of thyroid disease was

not discovered until 1882. “Graves’ disease is now affecting nearly 1 in every 200 people.

(Ahmed)” With such a high number of diagnoses, doctors should be working hard to find a cure;

however, advances in treatment have been slow for nearly 70 years. Excessive thyroid hormones

in the body can be cured; however, the underlying disease has not been. An abundance of new

therapeutic approaches involving biologic, small molecule, and peptide immunomodulation are

currently at different stages of development, and several will translate into clinical trials over the
3
Jurado

next few years. These therapies may render destructive radioiodine thyroid ablation and

thyroidectomy treatments obsolete.

If you are diagnosed with Hyperthyroidism through blood tests, your Endocrinologist will

likely start you on a regimen of medications. Therapy may include anti-thyroid medications that

will interfere with the use of Iodine in the thyroid to produce hormones. The use of Anti-thyroid

medications is not a cure and can result in relapse at any time. Most anti-thyroid medications can

cause rash, joint pain, liver failure, and decreased white blood cells that fight other diseases.

Beta-Blockers can be used in the treatment of Hyperthyroidism and will only aid in the relief of

Hyperthyroidism symptoms. Surgery is also an option to remove part or all the overactive

thyroid gland. The risk of surgery includes damage to the vocal cords and lifelong medication

use for Hashimoto’s Disease (Hypothyroidism). Lastly, radioactive iodine treatment may be

administered to shrink the overactive thyroid cells. Decreased thyroid function will cause the

thyroid activity to decline, and medication will likely be needed, life long, for thyroid hormone

replacement. Without life long, thyroid hormone replacement patients can live with symptoms

for many years. They will struggle with weight gain due to lack of metabolism, cold intolerance,

fatigue, lethargy, brain fog, dry skin, and thinning hair, joint pain and muscle weakness, trouble

sleeping and lastly constipation. The symptoms seem like those of hyperthyroidism. Many

patients wonder what the benefits of are having an underactive thyroid verse an overactive

thyroid. This would be a short list.

Two widespread symptoms of Graves’ disease include Graves’ ophthalmopathy and

dermopathy. Graves’ ophthalmopathy is the bulging of the eyeball from the socket. The bulging

of the eyeball is caused by the swelling of the tissue behind the eye. It can cause chronic dry eyes

and double vision. Depending on the severity of the swelling this symptom can become
4
Jurado

unsightly, causing facial deformity. With facial deformity the patient may feel depressed and

have hermit like behaviors because they simply do not want to be seen out in public. New

medication for this is being used to lessen the swelling in the tissue and has had lasting effects of

the eyeball protruding less over time. Graves’ dermopathy is treated using hydrocortisone creams

to relieve swelling and reddening of the skin on the shins and feet. Compression stockings can be

used to help relieve the swelling.

Graves’ disease symptoms do not seem very harmful or complicated to live with when in

black and white. However, the quality of life can be significantly affected by them. Not

remembering what task, you went into a room to do is quite dangerous and frustrating.

Depending on the type of thyroid nodule, some are hard, some are fluid filled, they may need to

be routinely drained, or surgically removed. Some nodules are small and can go completely

undetected. Others may be large enough to make swallowing difficult and can even make

breathing difficult. There is a small possibility that a thyroid nodule is cancerous. Tremors in the

hands are also a common symptom of overactive thyroids. Brain fog can lead to confusion,

anger, and anxiety. Muscle weakness can also be very dangerous for any individual. We hold the

weight of our body all day; with muscle weakness, someone can quickly become bedridden

without proper diagnosis and treatment. These symptoms can affect not only the patient but also

their families. Many adults before diagnosis find themselves unable to get through the day

without a nap or have difficulty concentrating on tasks that were once done with ease. Many

patients seek holistic approaches to alleviate symptoms. “Lifestyle changes focusing on rest and

relaxation seem to be the major strategies to alleviate brain fog symptoms. (Ettleson)”

While this disease is most common in women it is important to mention that men are

diagnosed with Graves Disease. The symptoms related to males having Graves’ Disease are
5
Jurado

different. Men’s sperm for example are greatly affected by Graves’ Disease. The lack of thyroid

hormone can reduce sperm density, and how well the sperm can move or swim. This is known as

motility. Thyroid disease is also associated with erectile dysfunction and can also lead to

complete infertility. Men are also likely to experience premature balding and overactive reflexes.

Gynecomastia, the enlargement of the male breast tissue, is also a known result of

hyperthyroidism in males. This is due to the lack of testosterone. It is equally important for men

to have regular testing done on thyroid hormone levels, especially if they have history of thyroid

disease or already a type two diabetic.

Neonatal Hyperthyroidism is not prevalent but is possible. Graves’ Disease has been

found to be genetic. Symptoms to watch for in small children are vomiting, diarrhea, low birth

weight, failure to thrive, enlarged soft spot, muscle weakness and bulging eyes.

As a patient dealing with Hyperthyroidism in my teens, it was hard to manage. I can

remember the event distinctly. I was trying out for the volleyball team in high school. We were

in the grueling week of conditioning. I couldn’t get up from the floor. My muscles were weak,

too weak for sixteen-year-old, five foot nine, one-hundred-and-thirty-pound girl. I was always

hot or cold, never comfortable with the temperature of the room. I had dizzy spells a few times.

We had tests done by a doctor and it was found that I had an overactive thyroid. After careful

consideration of the outcomes, and many doctor visits, my parents decided my best course of

treatment was radioactive iodine therapy. I was sixteen years old when my thyroid was no longer

functioning. I have had times of rebellion and stopped taking my medications. It did not go so

well and landed me in the hospital a few times. I have never felt entire body well. I am tired most

days, still too hot or too cold in every room. Thankfully I was able to have one full term birth,

but I do wonder if today will be the day that I will start to see symptoms of this disease in my
6
Jurado

own child since it has been found to be passed from mother to child. The worst symptoms I deal

with daily are my memory loss and weight. I find myself forgetting important meetings and have

walked into a room on numerous occasions just to stand there wondering why I went to the room

in the first place. I have trouble maintaining a healthy weight. It has caused depression, anger

and anxiety. I am active, very active and yet cannot lose weight. My endocrinologist has put me

on numerous weight loss medications in conjunction with my thyroid hormone replacement

medications. I know I will be dealing with this disease for the rest of my life because there are no

cures, no end in sight for the patients like myself struggling with the symptoms.

With high prevalence numbers and diagnoses on the rise, the hope for many patients, like

myself, is a cure on the horizon. Women’s health advocacies are stepping up to make Grave’s

disease more known since women are five to eight times more likely to be diagnosed

Hyperthyroid than men. It is now estimated that thirty to forty-eight million women in the US,

alone, have Hyperthyroidism, and half of those are undiagnosed. I would urge anyone male or

female to have thyroid hormone level testing included in their yearly screenings. The focus

should be placed on the symptoms and finding a cure to the underlying causes. Doctors need to

start screening for Hyperthyroidism in regular yearly exams to get a step ahead of this auto-

immune disease.
7
Jurado

Work Cited

Ahmed, A M, and N H Ahmed. “History of disorders of thyroid dysfunction.” Eastern

Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-

Majallah al-sihhiyah li-sharq al-mutawassit vol. 11,3 (2005): 459-69.

American Association of Clinical Endocrinology. “What is Hashimoto’s Thyroiditis?” YouTube

March 9, 2021, https://www.youtube.com/watch?v=CTio5gapNek

Horwitz, Jacqueline, and Judy Kaplan. "Hypothyroidism: A Women's Health Issue." The

Women's Health Activist, vol. 32, no. 1, Jan, 2007, pp. 6-7. ProQuest,

http://ezproxy.library.csn.edu/login?

url=https://www.proquest.com/magazines/hypothyroidism-womens-health-

issue/docview/236788725/se-2?accountid=27953.

Laura C Lane, Tim D Cheetham, Petros Perros, Simon H S Pearce, New Therapeutic Horizons

for Graves’ Hyperthyroidism, Endocrine Reviews, Volume 41, Issue 6, December 2020,

Pages 873–884, https://doi.org/10.1210/endrev/bnaa022

Monostra, “Michael. “Fatigue common with “brain fog” among adults with hypothyroidism.”

May 2021. https://www.healio.com/news/endocrinology/20210528/fatigue-common-

with-brain-fog-among-adults-with-hypothyroidism

Pitt, Susan. “What is Graves’ disease?” YouTube, UW Health, May 18, 2018,

https://www.youtube.com/watch?v=BjKf-FTfbjU