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Graves' disease
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Graves' disease

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DIABETES AND ENDOCRINE SYSTEM

Endocrine System

Graves disease, named after Robert J. Graves, MD, circa 1830s, is an autoimmune disease characterized by hyperthyroidism due to circulating autoantibodies. Thyroid-stimulating immunoglobulins (TSIs) bind to and activate the thyroid stimulating hormone (TSH) receptors, causing the thyroid gland to grow and the thyroid follicles to increase synthesis of thyroid hormone. Graves disease, along with Hashimoto thyroiditis, is classified as an autoimmune thyroid disorder. Graves' disease is the most common form of hyperthyroidism. It occurs when your immune system, which normally protects your body from bacteria and viruses, mistakenly attacks your thyroid gland and causes it to overproduce the thyroid hormone, thyroxine. This autoimmune response can also affect the tissue behind your eyes (Graves' ophthalmopathy) and the skin on your lower legs and feet (Graves' dermopathy).

When you have too much thyroid hormone in your system, your body's metabolism rate can increase by 60 percent to 100 percent, because thyroxine regulates your cells' metabolism. A higher metabolism can lead to a number of health problems, such as an irregular heartbeat or anxiety.

Graves' disease is rarely life-threatening. Although it may develop at any age and in either men or women, Graves' disease is far more common in women and usually begins between 20 and 40 years of age.

There's no way to stop your immune system from attacking the thyroid gland, but treatments can decrease the production of thyroxine.

Causes

Normally, your immune system uses naturally occurring proteins (antibodies) and white blood cells (lymphocytes) to help protect against viruses, bacteria and foreign substances (antigens) that invade your body. In Graves' disease, your immune system mistakenly attacks your thyroid gland, but instead of destroying the gland, an antibody called thyrotropin receptor antibody (TRAb) stimulates the thyroid to make excessive amounts of thyroid hormone.

Your thyroid is part of the endocrine system, which is made up of several glands and tissues that produce hormones. These chemical messengers coordinate many of your body's activities, from digestion to metabolism to reproduction. Thyroxine — a hormone produced by the thyroid — controls the metabolism of your cells.

Doctors don't know what causes your immune system to attack your thyroid gland. However, they believe a combination of factors including heredity, sex, age and stress may determine your likelihood of developing Graves' disease.

The autoimmune response that affects the thyroid gland can also cause an excessive accumulation of fluid in the tissue behind the eyes and in the muscles that move the eyes. This leads to enlargement of these tissues, which can push the eyeball forward, cause double vision and compress the optic nerve, causing decreased vision. This same process can occur in the skin, resulting in a thickened red rash, and typically occurs in areas subject to pressure or trauma, such as the shins and the tops of the feet.

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