Background information about the organ
The organ affected by Graves' disease is the thyroid gland. The thyroid is thumb-sized and is
located at the base of the neck in front of the windpipe and right below the Adam's apple. The thyroid
is a butterfly-shaped organ. It has two lobes connected to the isthmus in the middle. When it is in its
normal size, the thyroid can be felt moving up and down when one is swallowing. The thyroxine (T4) and
triiodothyronine (T3) and calcitonin are secreted in the thyroid which influences the body temperature,
growth development and metabolism stability (McCance et al., 2014). The extensive blood supply gives
the thyroid the reddish color. The thyroid gland secretes calcitonin which helps in the regulation of
calcium ions in the blood and other body fluids. Parathyroid hormone (PTH) is released in the
parathyroid gland, which is located on the posterior side of the thyroid gland. A negative feedback loop
is attested in the control of secretion of thyroid hormones. Triiodothyronine and thyroxine are secreted
and synthesized by the thyroid glands and are responsible for controlling metabolism in the body. This
happens when thyroid releasing hormone (TRH) is secreted by neurons in the hypothalamus. The TRH
the aids to the secretion of thyroid-stimulating hormone (TSH) by stimulating cells in the anterior
pituitary. The thyroid-stimulating hormone helps in the secretion of thyroid hormones which affects
almost all cells in the body. THS secretion is shut-off when TRH secretion is inhibited, which results in
shutting off thyroid hormone secretion. Negative feedback is relieved when the hormone thyroid levels
decay below the threshold.
Background information about the disease
Grave's disease is an autoimmune illness that results in an overactive thyroid gland that is
commonly termed as hyperthyroidism. The attack on a healthy issue by an immune system is what
results in an autoimmune disorder. Graves' disease occurs when the thyroid gland produces excessive
thyroid hormones as a result of an abnormal immune response. Hyperthyroidism is stimulated by
thyrotropin receptors. Hyperthyroidism is the main cause of Graves’ disease. The thyroid-stimulating
immunoglobins, which are the thyroid-stimulating antibodies, override the normal regulatory
mechanisms which result in the uncontrolled secretion of the thyroid hormones (McCance et al., 2014).
Graves' disease was initially referred to as exophthalmic goiter, and it was first described in 1835
by an Irish physician known as Robert James Graves. The disease is the number one cause of
hyperthyroidism. The disease is rarely a fatal disease, and not most individuals are well informed about
it. In 1840, Karl Adolph van Basedow also described the disease naming it Basedow's disease without
knowledge that the disease had already been described before.
What leads to the development of this disease?
Graves' disease is caused when the body's disease-fighting immune system malfunctions. It
develops from different factors ranging from environmental and genetic factors. The illness is
categorized as an autoimmune disease since an antibody called TSI is created by the body, and once it is
activated, it stimulates the thyroid to produce excess hormones that cause hyperthyroidism disorder.
The amount of iodine intake in the bloodstream is known to have an active impact on hyperthyroidism
and the enlargement of the thyroid gland, which is commonly visible as goiter.
Although Graves’ disease can affect anyone, It more common in young people and in women.
There exist many other factors that heighten the risk of an individual acquiring the disease. Graves’
disease is an immune system disorder, and a person's family history is a huge risk factor. A family history
of Graves' disease can make an individual more vulnerable to the condition. The risk of getting the
illness is also heightened by the presence of other autoimmune diseases such as type 1 diabetes or
rheumatoid arthritis. Pregnancy and smoking also increases the risk of the disorders (Menconi,
Marcocci & Marinò, 2014). Cigarette smoking has a significant effect on the immune system which
heightens the risk of getting the Graves' disorder.
Virtually all the signs and symptoms of the Graves' condition result from the indirect or direct
impacts of hyperthyroidism. An excessive number of thyroid hormones can result in symptoms such as
irregular heartbeat, fatigue, anxiety, increased sweating, diarrhea, bulging of the eyes, trouble sleeping
and hand tremors. Additionally, the patient can experience frequent defecation, heat intolerance,
weight loss and partial muscle weakness or paralysis, among other symptoms. Upon physical
examination by the physician, other signs are evident such as diffusely enlarge and non-tender thyroid.
People with the condition may also experience personality and behavioral change, including depression,
agitation, psychosis and mania (McCance et al., 2014).
Physicians conduct physical examinations when diagnosing Graves' disease to check on the signs
and symptoms. The doctors may also discuss family history or medical history. If the signs and symptoms
are not visible, the doctor may also conduct blood tests, radioactive iodine tests, ultrasound tests and
imaging tests. The stimulating hormone (TSH) and the levels of thyroid hormones can be determined
through blood tests. The rate at which the thyroid gland takes up iodine can be determined to help
determine if Graves' condition is the cause of hyperthyroidism. If the clinical tests are not clear, imaging
tests such as CT scan or MRI are used to determine if a person has the condition (Menconi, Marcocci &
Medication, thyroid surgery and radioiodine therapy are the most common forms of treatment
of Graves' disease. Radioiodine therapy is commonly used in the treatment of the condition and it
involves taking a dosage of iodine capsules that are radioactive via the mouth. The radioactive capsules
destroy the thyroid gland's cells that secrete the thyroid hormones. Beta blockers are the medication
taken to lessen the symptoms of Graves' disease before other medications work. Antithyroid medicines
are used to reduce the number of thyroid hormones produced (McCance et al., 2014). The medications
do not offer a permanent cure for the disease but are the most suitable route for breastfeeding and
pregnant mothers. The treatment method, which is less common is a surgery that helps to remove the
thyroid. However, after the surgery, the patients have to take medication to keep the thyroid levels at a
level which is safe.
The disease can be prevented by maintaining a healthy lifestyle such as reducing stressors,
exercising regularly and avoiding smoking. Also, individuals should refrain from the disease by trying to
obtain low iodine dairy products and seafood. Individuals should limit the amount of meat that they
take in due to the high amounts of iodine that they contain. Also, it is key to keep a record of one's
family and medical history so that the right information can be communicated to the doctors for better
management of the condition (Smith & Hegedüs, 2016).
Prevalence around the world
Graves' disease affects around 1 in 200 individuals. The disease is more prevalent in women and
young individuals who are below 40 years. The prevalence of the disease significantly varies according to
race and ethnicity. It is the most common cause of hypothyroidism in the United States and in other
countries globally. Globally, the disease occurs in about 0.5% individuals, and it happens 7.5 times more
often in the women than men which are attributed to hormonal factors (Smith & Hegedüs, 2016).
Mostly, the disease starts in individuals who are aged between 4o years and 80 years of age (Smith &
The current research being embarked on is finding a cure for Graves' disease. Scientists and
researchers are working towards producing a regulating stimulus hormone for the TSI antibody. Scientist
are therefore working towards finding a safer and more effective alternative cure for Graves' illness
(Smith & Hegedüs, 2016).
Graves' disease is an autoimmune disorder which can have minimal or severe impacts
depending on if the proper treatment was given and the time when the illness was diagnosed. The cause
of the disease has not yet been determined, but it is attributed to genetic and environmental factors.
The condition can be prevented by a healthier diet, exercise and low iodine intake. The symptoms
should not be ignored, and the medication should be taken as administered by the physicians.
Menconi, F, Marcocci, C, & Marinò, M. (2014). Diagnosis and classification of Graves' disease.
Autoimmunity Reviews. 13(4–5): 398–402. doi:10.1016/j.
McCance, K. L., Huether, S. E., Brashers, V.L., & Rote, N. S. (2014). Pathophysiology: The biologic basis for
disease in adults and children (7th ed.). St. Louis: Mosby. (ISBN: 9780-323-08854-1)
Smith, T. J., & Hegedüs, L. (2016). Graves’ disease. New England Journal of Medicine, 375(16), 1552-
1565. Retrieved 13 September 2020, from https://www.researchgate.net/scientific-