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General Practice 2023

Graves's Doença: what é, symptoms, causes and treatment

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Graves's Doença: what é, symptoms, causes and treatment
Graves's Doença: what é, symptoms, causes and treatment

Graves disease is an autoimmune disease of the thyroid characterized by the excessive production of hormones by this gland, causing hyperthyroidism, which leads to the appearance of symptoms such as nervousness, weight loss even with increased appetite, bulging eyes or palpitations for example.

This disease is the main cause of hyperthyroidism, and affects more women than men, mainly between 20 and 50 years old, although it can appear at any age.

Graves disease is treated by the endocrinologist, who may indicate the use of drugs, radioactive iodine therapies or thyroid surgery, for example, to control the disease, avoiding complications such as congestive heart failure or osteoporosis.


Main symptoms

The symptoms presented in Graves' disease depend on the severity and duration of the disease, and on the patient's age and sensitivity to excess hormones, usually appearing:

  • Hyperactivity, nervousness and irritability;
  • Excessive heat and sweat;
  • Heart palpitations;
  • Weight loss, even with increased appetite;
  • Diarrhea;
  • Excessive urine;
  • Irregular menstruation and loss of libido;
  • Trembling, with moist and warm skin;
  • Goiter, which is an enlarged thyroid, causing swelling in the lower part of the throat;
  • Muscle weakness;
  • Gynecomastia, which is the growth of breasts in men;
  • Eye changes such as bulging eyes, itching, tearing and double vision;
  • Pink plaque-like skin lesions located in regions of the body, also known as Graves' dermopathy or pretibial myxedema.

In the elderly, signs and symptoms may be more subtle, and may manifest as excessive tiredness and weight loss, which can be confused with other diseases.

Although Graves' disease is the main cause of hyperthyroidism, it is important to be aware because the excess production of thyroid hormones can be caused by other problems, so here's how to identify the symptoms of hyperthyroidism and the main causes.

How to confirm the diagnosis

The diagnosis of Graves' disease is made by evaluating the symptoms presented, blood tests to measure the amount of thyroid hormones, such as TSH and T4, and immunology tests to see if there are antibodies in the body. blood against the thyroid.

In addition, the doctor may order tests such as thyroid scintigraphy, computed tomography or magnetic resonance imaging, including to evaluate the functioning of other organs, such as the eyes and heart. Here's how to prepare for a thyroid scan.

Possible causes

Graves disease is an autoimmune disease caused by which the immune system reacts against the cells of the thyroid gland, attacking these cells as if they were foreign to the body, altering its functioning and causing the thyroid to become more active, which leads to the appearance of symptoms.

However, it is not yet known exactly why this happens, but some factors seem to contribute to its development such as:

  • Gender and age, being more common in women over 40;
  • Family history of Graves' disease;
  • Physical and emotional stress;
  • Smoking;
  • Pregnancy or recent childbirth, in women who have genes that increase the risk for this disease.

In addition, a history of other autoimmune diseases, such as type 1 diabetes or rheumatoid arthritis, for example, can also increase the risk of developing Graves' disease.

How the treatment is done

The treatment of Graves' disease is indicated by the endocrinologist, guided according to the clinical condition of each person. It can be done in 3 ways:

  1. Use of antithyroid medications, such as Methimazole or Propylthiouracil, which will decrease the production of thyroid hormones and antibodies that attack this gland;
  2. Use of radioactive iodine, which causes destruction of thyroid cells, which ends up decreasing their production of hormones;
  3. Surgery, which removes part of the thyroid to decrease its production of hormones, is performed only in patients with drug-resistant disease, pregnant women, suspected cancer, and when the thyroid is very bulky and presents symptoms such as difficulties in eating and speaking, for example.

Medicines that control the heart beat, such as propranolol or atenolol, may be helpful in controlling palpitations, tremors and tachycardia.

In addition, patients with severe eye symptoms may need to use eye drops and ointments to relieve discomfort and moisturize the eyes, and it is also necessary to stop smoking and wear sunglasses with side shields.

See how food can help in the following video:

Graves disease is not usually cured, but spontaneous remission of the disease may occur in some people or after a few months or years of treatment, but there is always a chance that the disease will come back.

Treatment in Pregnancy

During pregnancy, this disease should be treated with minimal doses of medication and, if possible, discontinue medication in the last trimester, as antibody levels tend to improve towards the end of pregnancy.

However, special attention needs to be paid to the disease during this stage of life because, when in high levels, thyroid hormones and medications can cross the placenta and cause toxicity to the fetus.

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