Unpleasant Manifestations of Graves' Disease - Research Paper Example

? Graves’ disease Graves’ disease “Graves’ disease, a type of hyperthyroidism, is caused by a generalized over activity of the entire thyroid gland. It is named for Robert Graves, an Irish physician, who was the first to describe this form of hyperthyroidism about 150 years ago” (Graves’ disease, 2005, p.1). Boyanov, et al. (2010) have pointed out that “Graves’ ophtalmopathy (GO) is a potentially serious ocular complication of the auto-immune thyroid disease (AITD)” (Boyanov, et al, 2010, p.51).Graves' disease is a thyroid related disease in which the thyroid hormones will be produced more in quantity than required by the body. The over activity of thyroid may cause hyperthyroidism or imbalances in the thyroid hormone levels. TSHR-Ab (Thyrotrophin stimulating hormone receptor autoantibodies) and TSHR (Thyrotrophin stimulating hormone receptor) are the major hormones which causes hyperthyroidism. Graves' disease is believed to be the most common cause of hyperthyroidism, and it normally appears during adolescent period. It is difficult to treat Graves' disease. Apart from hyperthyroidism, skin diseases eye diseases etc are other major symptoms of Graves disease. Graves’ disease is the only kind of hyperthyroidism which results in inflammation of the eyes, swelling bulging of the eyes (called Graves’ ophthalmopathy). Even though medical science has advanced a lot, still we are unable to find out the reasons for the inflammation of eyes as a result of Graves disease. Redness and irritations are other major eye problems developing as a result of this disease. Eye problems can be developed before and after the diagnosis of Graves disease. The severity of eye problems has nothing to do with the severity of the disease (Graves’ disease, 2005, p.1). Patients with Graves’ disease usually develop a reddish appearance of the skin in front of the shins. Skin problems occur only bin rare cases of Graves disease. These problems are painless and not much serious. As in the case of eye problems, it is not necessary that skin problems should develop before or after the diagnosis of Graves disease (Graves’ disease, 2005, p.1). The exact cause of Graves disease is still unknown. It is believed that this disease is caused by some irregular processes in our immune system. It should be noted that immune system is usually protecting our body from the attack of outsiders such as viruses, bacteria, fungi. Immune system counters the attacks of outsiders with the help of antibodies produced in our body. In Graves disease, immune system provide wrong message to antibodies so that it may force thyroid cells to produce more thyroid hormones. It is already proved that thyroid and some of the psychological diseases have definite relationships. Because of the above fact, many physicians do believe that emotional problems can also cause Graves disease. Diagnosis of Graves disease is usually made with the help of physical examination and laboratory tests such as blood tests and scanning. The amount of Thyroid hormones such as T3 T4 and TSH (thyroid-stimulating hormone) are usually taken for the diagnosis purpose. Treatment of thyroid is usually done with the help of medications such as methimazole, or Tapazole, propylthiouracil [PTU]) and radioiodine. In extreme cases or in cases of tumors, surgery is the only option available for curing Graves disease (Graves’ disease, 2005, p.2). Statistical data for people within the US dealing with Graves In 1996, 3,048,636 people in the USA were diagnosed with Graves disease. In other words, one in every eighty nine American people may have this disease. Moreover, approximately 136,000 additional Americans were diagnosed with this disease every year (Statistics about Graves Disease, 2011). According to the statistics released by The National Institutes of Health (NIH) in 2010, “Graves’ Disease affects approximately 2 to 3% of the population or almost 10 million people. Graves' is five to 10 times more common in women than men. Graves' usually occurs in middle age, but also occurs in children, adolescents and the elderly” (About Graves' Disease, 2010). Many people believe that the above figures are much lesser than the actual cases of Graves disease in America. It is because of the fact that many of the Graves disease quite often reported only at the latter stage. Nobody will bother much about the skin problems or minor eye problems initially. Only when the symptoms become intensified, people seek medical attention and the diagnosis of the disease will be done. Social challenges of patients It is quite impossible for someone who has never experienced the attack of Graves' Disease on the body and brain to understand how difficult it can be simply trying to function or get through each day. Relationships and careers can be damaged, sometimes permanently. People tend to view the erratic behavior of the Graves' patient as part of their personality, or in terms of character defects. Many people with Graves' have had it a long time before it was diagnosed, and a lot of damage may have been done already without anyone having a clue that an illness is responsible (Living with Graves, 2004). There are many cases of divorce as a result of Graves disease. As mentioned earlier, bulging of eyes is a major symptom of this disease and this symptom can be quite misunderstood. Instead of taking it as a symptom of disease, people may take it as a behavioral problem or mental disorder. It should be noted that bulging or inflammation of eyes may damage the normal appearance of the patient. All these factors may finally end up in a divorce in the case of spouses. As mentioned earlier, all thyroid problems can cause many psychological problems. In other words, physical problems such as thyroid can cause mental problems. So, people should take extreme care while somebody in their family or immediate neighborhood behaves abnormally. In other words, before handing over a mental patient to a psychiatrist, people should seek the opinions of a physician in order to make sure that his problems were not developed as a result of any physical problems such as thyroid. It should be noted that once a patient is wrongly diagnosed for mental problems, the black mark may remain on him/her for his/her entire life span. People with Graves disease may not be able to work normally with others since colleagues may look suspiciously at the patient. Because of the lack of knowledge about this disease, colleagues may misunderstand it as an epidemic disease or communicable disease. So they will try to isolate the patient from their company which will make psychological problems in the minds of the patient. Two research projects concerning Graves' Disease Boyanov et al. (2010) have conducted a research at Endocrinology Clinic, Department of Internal Medicine, Alexandrovska University Hospital, Medical University Sofia, Sofia, Bulgaria among 98 patients with Graves’ disease (GD) including 76 women and 22 men, in order to learn more about GD. They found that out of the 98 subjects, Thirty-nine patients had manifested GO - 28 women, 11 men. After analyzing the result they concluded that higher levels of Thyroglobulin antibodies (TGAb) and Thyroid Autoantibodies such as TRAb and TPOAb are found in patients with GD (Boyanov, et al, 2010, p.50) Ben-Skowronek et al. (2009) at Departments of Paediatric Endocrinology and Neurology, and Pathomorphology, Lublin Medical University, Lublin , Poland, have conducted another study among 30 children with Graves’ disease, 30 children with nodular goiter, 30 with simple goiter and 30 healthy children. After the analysis of results they concluded that “The immune reaction in Graves’ disease and migration of lymphocytes T and B between thyrocytes results in the thickening of the basal membrane of the thyroid follicle. No cytotoxic effect of T cytotoxic/ suppressor CD8+ cells on thyrocytes was observed in Graves’ disease, while a mild cytotoxic effect was observed in non-autoimmune thyroid disease” (Ben-Skowronek et al, 2009, p.350) Two interventions that could help minimize the impact Graves disease “Patients with severe eye involvement may need treatment with Steroid hormones, immunosuppressive agents, radiation, or surgery and such patients should see an ophthalmologist”(My Thyroid, 2005). Since eye bulging is the major irritation occurs to the patient, interventions necessary to reduce this problem are necessary. It should be noted that people who watches a Graves patient may make irritating comments which may create immense stress in the minds of the patient. Steroid treatment for eye problems should not be continued more than few days as it may develop other side effects. Some studies have shown that steroid therapy twice in every week yields better results than continuous steroid therapy. Radioactive iodine therapy is used in complex cases of Graves disease. In this therapy the patient is advised to take radioactive iodine capsule or drink water containing radioactive iodine. In some cases, the nodule or the goiter caused by Graves disease may contain tumor cells. In such cases, surgical removal of the tumor is the only option left for Graves patients. Conclusions The exact reasons for Graves disease is still unknown. However, it concluded that this disease can cause hyperthyroidism or excessive production of thyroid hormones. Eye bulging and skin problems are other major symptoms of this disease. Diagnosis is usually done with the help of physical examination, blood testing scanning etc. Medications and surgeries are used as the treatment options for Graves disease. Proper awareness about Graves disease will help people to avoid social challenges developed as a result of this disease. References About Graves' Disease (2010), Retrieved from http://www.ngdf.org/pages/6 Boyanov M, Bakalov D., and Sheinkova G. (2010). Levels of Thyroid Autoantibodies in Patients with Graves’ Disease and Graves’ Ophtalmopathy. Turkish Journal of Endocrinology and Metabolism, published by Galenos Publishing, September 1, 2010. Ben-Skowronek I., Sierocinska-Sawa J., Szewczyk L., and Korobowicz E. (2009). HORMONE RESEARCH 2009;71:350–358. DOI: 10.1159/000223420 Graves’ disease (2005), American Thyroid Association. Retrieved from http://www.thyroid.org/patients/brochures/Graves_brochure.pdf Living with Graves (2004), Retrieved from http://home.rmci.net/deecee/information.htm My Thyroid (2005). Retrieved from http://mythyroid.com/eyedisease.html Statistics about Graves Disease (2011), Retrieved from http://www.rightdiagnosis.com/g/graves_disease/stats.htm Read More