Fatigue, racing heartbeat, weight loss. When Star Wars actress Daisy Ridley was plagued by these symptoms, she thought it was just stress that was getting to her. She was filming her movie Magpie at the time and felt that these symptoms were due to the pressure of the role. However, she informed her fans recently that in September last year, she came to realise that she was suffering from Graves’ disease after she consulted with an endocrinologist. Graves’ disease is a rather uncommon disorder that is caused in the body due to an overproduction of thyroid hormones. It can leave you with bouts of sleeplessness, irritability as well as excessive sweating, and can be life-threatening if not treated on time.

What is Graves’ disease?

Graves’ disease is an autoimmune condition that affects the thyroid gland, a butterfly-shaped gland located at the front of the neck, just under the voice box. “This disease causes the gland to produce an excessive amount of thyroid hormones, leading to a condition called hyperthyroidism,” explains internal medicine specialist Dr Basavaraj S Kumbar. Since these hormones play a crucial role in regulating the body’s temperature and heartbeat, people with Graves’ disease may experience issues in various organs.

According to the US National Institute of Diabetes and Digestive and Kidney Diseases, Graves’ disease attacks your thyroid gland, and causes it to produce more thyroid hormones. This results in your body’s functions speeding up. This condition is most commonly observed in women and individuals over the age of 30.

Symptoms of Graves’ disease

The symptoms can be quite varied, often including:

• Overactive metabolism, which results in unintentional weight loss despite an increased appetite and rapid heartbeat.
• Bouts of sleeplessness
• Irritability
• Nervousness
• Sweating.
• Muscle weakness and shaky hands
• Irregular bowel functions
• Enlarged thyroid gland, also known as goitre.

However, these are quite common symptoms for many other diseases as well and it is always recommended to visit a healthcare professional for a correct diagnosis, explains Dr Kumbar.

Graves disease can also cause eye diseases such as irritated eyes, puffy eyes, bulging eyes, as well as pain and pressure in your eyes.

Causes of Graves’ disease

Graves’ disease is caused when a person’s immune system starts attacking the thyroid gland. Although no specific reason has yet been discovered that could help you understand why you have been affected by Graves’ disease, there are a few reasons that could justify its presence in the body.

1. Genetic predisposition

People who have a family history of autoimmune disorders are usually at a higher risk of developing the condition due to specific affected genes. A study, published in Reviews in Endocrine and Metabolic Disorders, states that genetic factors may put you at a 60-80 percent increased risk of developing Graves’ disease. Genetic factors can also determine the severity of the disease such as the age of the onset of GD, the severity of thyrotoxicosis, a rare and life-threatening complication, size of goitre as well as relapse of hyperthyroidism, even after an anti-thyroid drug therapy.

2. Environment and lifestyle changes

Factors such as stress, infections, and exposure to certain chemicals or toxins can also trigger Graves’ disease, especially in people with genetic predisposition. A study published by StatPearls also states that many environmental factors such as pregnancy and postpartum recovery, an excess of iodine, several infections, emotional stress as well and a habit of smoking can lead to Graves Disease.

3. Hormonal changes

Changes in hormone levels, specifically during pregnancy or menopause in women, can influence the development of Graves’ disease by altering immune function and thyroid activity. A study published in Clinical Diabetes and Endocrinology, analyses the risk of Graves’ hyperthyroidism in pregnancy. It states that the symptoms of Graves’ disease in pregnancy remain the same as what patients experience when they are not pregnant. Pregnant women who had symptoms before the pregnancy had a prior diagnosis of hyperthyroidism, and have an older child with thyroid dysfunction are most at risk of Graves disease. Check out if thyroid disorders can cause early menopause.

4. Smoking

Smoking regularly significantly increases the risk of attaining this disease as tobacco intake affects hormone levels and thyroid functions. A study published by JAMA, states that not only is smoking associated with the cause of Graves Disease, but it increases the risk of its severity as well.

How is Graves’ disease diagnosed?

In diagnosing Graves’ disease, doctors use a range of methods including medical history, physical examination, blood tests to measure thyroid hormone levels, and identification of specific thyroid autoantibodies such as thyroid-stimulating immunoglobulins (TSI), explains Dr Kumbar. In some cases, imaging studies like a radioactive iodine uptake test or a thyroid scan may be performed to assess the thyroid gland’s activity and provide more information about the disease.

Treatment of Graves’ Disease

Treating Graves’ disease involves a combination of approaches aimed at managing the symptoms and addressing hyperthyroidism caused by the condition.

1. Anti-thyroid medications

One common method is the use of anti-thyroid medications, which help to reduce the production of thyroid hormones. The American Thyroid Association cites anti-thyroid medications to be the best and first round of treatment for Graves’ Disease. It states a study about how anti-thyroid medications have shown a great result in Graves’ disease patients in Sweden, with the remission rates being much higher.

2. Radioactive iodine therapy

In some cases, radioactive iodine therapy may be recommended, where a radioactive form of iodine is taken to destroy overactive thyroid cells, leading to a decrease in hormone levels. A study, cited by the US NIH and published in the Malaysian Journal of Medical Sciences, states that this therapy destroys thyroid tissues due to iodine, which is the precursor of thyroxine. This leads to a decrease in the volume of thyroid tissues. The dose depends on the ultrasound determination of the volume of the thyroid gland and the iodine uptake of the body.

3. Surgical interventions

In more severe cases, surgical intervention to remove part or all of the thyroid gland may be necessary. The American Thyroid Association states that in these procedures, a cut is made on the front side of your neck, with the blood vessels to the thyroid being controlled well by the surgeon. The thyroid is removed then, and the surgeon protects the nerves responsible for your vocal cords and the parathyroid glands. It also states that pregnant women, who want to stay away from radiation, can go in for a surgical consultation for Graves disease.

4. Regular monitoring

Regular monitoring by a healthcare provider is essential to adjust treatment plans and ensure that hormone levels remain stable. A study, published in StatPearls suggests that thyroid function tests should be done every four to six weeks, following treatment. Side effects also need to be monitored and blood tests need to be performed by your doctor.

5. Lifestyle changes

Lifestyle changes, such as a balanced diet and stress management, can also support overall health during treatment. Eating a nutritious diet with lots of fresh fruits and vegetables might be recommended by your doctor. A study, published in Advances in Mind-Body Medicine, states that a healthy lifestyle is the first level of intervention.

Graves disease diet: What to eat?

Certain foods are sure to help you through your diagnosis and recovery of Graves’ disease. Including calcium-rich foods such as broccoli, kale, chia seeds as well as salmon can help you feel better. However, make sure to check the iodine levels in calcium-rich food options as more iodine can worsen your symptoms, states the National Institute of Diabetes and Digestive and Kidney Diseases. Foods containing selenium can also help you with thyroid eye disease, which is related to Graves Disease, states a study, published in Frontiers in Endocrinology. Foods such as brown rice, sunflower seeds and tuna can help. Check out some diet tips to manage the thyroid. Consuming Brazil nuts for thyroid can be helpful too.

Can you prevent Graves’ Disease?

No, unfortunately, this autoimmune condition cannot be prevented. While there is no cure for this disease, your symptoms can be managed better by following the right course of medication and lifestyle changes.