It is a life-threatening disease of the thyroid gland. In this article you will find the answer to the question “What is Graves’ disease?” Good day, dear reader. My name is Dilyara Lebedeva, I am the author of the blog you are currently on - “Hormones are normal!” If you would like to know a little more about me and the blog, then please visit the “About the Author” page. And now I will continue my story.

In this condition, the body produces excessive amounts of thyroid hormones. Women are more susceptible to developing this thyroid disease than men. Statistics show that hormonal disorders of this nature most often develop in young and middle-aged people.

Why does Graves' disease occur?

Graves' disease is an autoimmune disease caused by dysfunction of the human immune system. The main reasons for this state of the body include:

1. Hereditary predisposition.
2. Long-term course of infectious diseases.

Diffuse toxic goiter quite often occurs as a result of complications after suffering from chronic tonsillitis. Also, this thyroid dysfunction can be triggered by certain autoimmune diseases. Uncontrolled long-term use of medications containing iodine, as well as prolonged stressful situations, can cause Graves' disease.

Main signs of Graves' disease

The course of the disease in the early stages of its development occurs almost imperceptibly for the patient - he feels severe fatigue, fatigue, increased weakness and sweating. Often this condition is also accompanied by poor sleep and sudden mood swings. Sleep disturbance is manifested by prolonged difficulty falling asleep, short sleep duration, and frequent awakenings.

Over time, the heartbeat begins to quicken, periodically the patient feels trembling of the legs, arms, and then the whole body. In most cases, with the development of Graves' disease, patients sharply lose weight; only sometimes those affected by this disease can gain it.

Gradually, the patient’s skin may become darker, and swelling may occur in the legs.

A disturbance in carbohydrate metabolism becomes inevitable, which often becomes the cause of diabetes. With this disease, the thyroid gland rapidly enlarges and thickens, but there is no pain. With an enlarged thyroid gland, the patient may experience difficulty breathing.

Increased functionality of the thyroid gland and the production of excessive amounts of the hormone adversely affect the activity of all internal organs of the human body. The following changes are observed:

1. The heartbeat quickens, blood pressure rises, heart rhythm disturbances occur, and pain in the heart is observed.
2. The eyes become enlarged, the eyelids swell, the blood supply to the eyeball deteriorates, which can cause inflammation of the optic nerve and the manifestation of conjunctivitis. Over time, vision can deteriorate significantly, and often this condition of the visual organs leads to absolute blindness.
3. The activity of the central nervous system also changes - insomnia, headaches, dizziness are observed, and there is a feeling of inexplicable anxiety.
4. The functioning of the digestive system organs deteriorates - nausea is present, liver dysfunction occurs, and diarrhea occurs.
5. Disturbances in the functioning of the reproductive system occur - impotence develops in men, and the menstrual cycle is disrupted in women, which often becomes the cause of infertility.

Increased vulnerability and sensitivity are constant companions of patients with diffuse toxic goiter. They are tearful, irritable, and intolerant of bright light, sound and touch.

Degrees of the disease

According to the nature of the course of the disease in medicine, it is customary to distinguish three degrees - mild, moderate and severe.

At mild form During the course of Graves' disease, the patient's condition is satisfactory. Heart rate does not exceed 100 beats per minute. Weight decreases slightly.

Average degree The disease is accompanied by a heart rate of more than 100 beats, weight begins to decrease by 20% of the original, and increased blood pressure is observed.

Severe form The disease is accompanied by increased heart rate - more than 120 beats, weight is also greatly reduced - more than 20%, and damage to other internal organs of the body occurs.

How to identify Graves' disease?

Graves' disease is diagnosed based on the clinical picture. Specialists can detect the disease by palpating the thyroid gland, using ultrasound, and also by examining the amount of hormones produced by the thyroid gland.

One of the methods for diagnosing Graves' disease in controversial cases is radioisotope scanning, which makes it possible to determine functionally active tissue, the presence and size of nodular neoplasms.

Effective treatment methods

Today, there is no specific treatment method for diffuse toxic goiter. It is customary to distinguish several methods, which are used depending on the form of the disease, as well as on the size of the enlarged gland.

The main treatment methods include:

1. Drug treatment.
2. Radioactive irradiation with iodine.
3. Surgical intervention.

Medication method

At the first stage, specialists prescribe one of the existing thyreostatic drugs. For a significant proportion of patients, this treatment is sufficient to eliminate all symptoms. But, unfortunately, situations are often observed when, when taking such drugs, the disease returns again. Here surgical removal of the thyroid gland becomes inevitable. It would also be appropriate to use a method in which the thyroid cells are killed with radioactive iodine.

Drug treatment is indicated for children and adults under the age of 25 years. Their action is aimed at inhibiting the functions of the thyroid gland. The use of such drugs is prescribed to reduce the manifestations of the main symptoms in patients of any age, as well as before a planned operation aimed at removing part of the thyroid gland. These drugs include mercazolil, tyrosol, propicil. The dose is prescribed depending on the severity of thyrotoxicosis.

Other medications that work by lowering heart rate include beta blockers. These substances are able to block the effect of excess thyroid hormones on the heart and other organs of the patient's body, but they do not have any effect on the thyroid gland itself.

Treatment with radioactive iodine

Radioactive iodine is usually given in capsule form. The required radiation dose is determined based on the size of the diffuse goiter. To do this, specialists conduct a test for “absorption by the thyroid gland” of the drug. Absorbed by the body, iodine accumulates over time and, as a result, leads to the death of an excess number of gland cells. This treatment quickly leads to positive results; after several procedures, the patient no longer feels the symptoms of Graves' disease so acutely. Sometimes doctors use radioactive iodine to completely suppress the functioning of the thyroid gland.

Despite the fact that treatment using radioactive iodine for a short time gives effective therapeutic results, it should still be used with caution for children and young people, since radiation can adversely affect the functioning of many body systems.

Surgical method of treatment

Thyroidectomy as a type of surgery is recommended for patients under the age of 20 years when there is a relapse of the disease while taking medications. Also, surgical intervention becomes inevitable in situations where the goiter reaches such a size that the patient’s throat is severely compressed and the process of breathing and swallowing food becomes difficult.

Experts say that as a result of thyroidectomy and treatment with radioactive iodine, a small part of the thyroid gland remains, which does not allow this vital organ to fully function. Therefore, after such treatment, replacement therapy with thyroxine preparations is prescribed.

Prevention

After treatment of Graves' disease, as well as for the purpose of prevention, doctors recommend their patients to adhere to a certain lifestyle that will avoid relapse of the disease. First of all, it is important to follow the recommended hygiene regime. In addition, you should avoid any stressful situations, this is especially worth considering for girls and women experiencing their first menstruation or menopause. Hydrogen sulfide or sunbathing and sea bathing are strictly contraindicated for them.

I described in detail the restrictions and prohibitions for this disease in the article. Be sure to read it, there are a lot of useful tips there.

Physical and emotional stress should be avoided. It is useful during this period of life to adhere to a diet consisting mainly of carbohydrates, which will help restore liver and muscle function and strengthen skeletal muscles.

The daily diet should include foods containing large amounts of vitamins, especially thiamine and potassium salts. You should be careful when consuming foods that are sources of iodine. To avoid the development of the disease, you should undergo regular thyroid examinations, as well as avoid stress and promptly treat infectious diseases.

Graves' disease occurs when there is dysfunction of the thyroid gland, expressed by an enlargement of the glandular organ and its excessive activity in the production of hormones.

Bazedow's disease is one of the autoimmune diseases in which the immune system begins to perceive the body's own cells as harmful. This pathology mainly affects women.

With significant hyperfunction of the thyroid gland, Graves' disease occurs, and there is a noticeable reactivity of the nervous system. The medical name for Graves' disease is diffuse toxic goiter.

The disease is characterized by increased tissue metabolism and reproduction of the hormone thyroxine in excessively high concentrations. At the same time, numerous changes are observed in each of the body systems.

Interesting!

According to statistics, Flayani Disease is the 2nd most common among all thyroid pathologies (1st place - hypothyroidism). This pathology can occur in 1 person out of 100.

Pathology is usually divided according to degrees of severity:

1. Mild degree. For the most part, it has an inconspicuous course, the patient’s condition is considered satisfactory.

The contraction frequency of the heart muscle is within 100 beats/min. Weight loss does not exceed 10% of normal.

1. Average degree. Blood pressure readings are elevated, the frequency of contractions of the heart muscle exceeds 100 beats/min.

Lack of weight is about 20% of normal.

1. Severe degree. There are multiple lesions of other systems and their organs.

The frequency of contractions of the heart muscle is over 120 beats/min. Weight loss exceeds 20% of normal.

In this case, there is a lack of oxygen - the patient requires approximately 80% more oxygen in comparison with healthy people of the same physical parameters.

The disease develops between the ages of 25 and 40 years.

Interesting!

Quite often the disease is transmitted through 1 generation, mainly through the female line.

Perry's disease (Bazedow's disease) most often occurs in those who have a family history of thyroid disorders.

Causes

The occurrence of diffuse toxic goiter is caused by a combination of certain internal factors with some external influences.

However, such an immune reaction to the body’s own cells can only occur when exposed to external stimuli, but subject to a genetic predisposition.

The specific causes of Graves' disease have not been fully established. However, a number of predisposing factors have been identified that can cause the development of pathology:

1. Genetic predisposition.
2. Pathologies that are caused by the penetration of pathogenic microorganisms into the body, including colds and ENT diseases.
3. Trauma to the brain and cranium.
4. A long period of taking a certain number of medications (for example, with high concentrations of radioactive iodine in the body).
5. It is generally accepted that Graves' disease can be triggered by excessive consumption of alcohol-containing drinks and smoking.
6. Excessive psycho-emotional stress.

The only thing that has been proven is that the acute form of diffuse toxic goiter occurs as a result of psycho-emotional shocks.

The first signs of Graves' disease or an exacerbation of its course occur with the following pathologies:

• chorea;
• flu;
• rheumatisms;
• acute tonsillitis;
• tuberculosis.

However, for the most part, it is not possible to identify the true provoking factor in the patient.

Interesting!

In women, Basedow's disease occurs 6 times more often, which is explained by the increased efficiency of the endocrine system than in men.

Despite the fact that the causes of Graves' disease have not been definitively established, the symptoms and other characteristic signs have been studied sufficiently for successful diagnosis.

Signs

For the most part, the disease begins unnoticed by the patient. General health gradually deteriorates, while the characteristic signs of hyperthyroidism become more pronounced:

• causeless mood swings;
• tremor;
• sleep disorders;
• increased sweating;
• excessive fussiness;
• feeling of increased heartbeat;
• weight loss

In addition, due to the characteristics of each person’s body, immune system, and the complexity of the disease, external manifestations are also very different and varied, which further complicates timely diagnosis and makes it difficult to make a correct diagnosis.

For example, in some cases, a slight weight gain is possible. The skin becomes slightly darker and mild swelling of the legs may occur.

The patient has difficulty withstanding heat and is haunted by a feeling of heat throughout the body. At the same time, the symptoms of Graves' disease are in many ways similar to those of hypothyroidism.

Hypothyroidism is quite often the initial form of toxic diffuse goiter.

With Graves' disease, disorders of the following organ systems develop:

1. Organs of vision. Exophthalmos (eyes wide open) appears, the eyes are bulging and enlarged. There may be “double vision” or a feeling of “sand”. There are pathologies in the blood supply to the eyeball, which provokes the formation of conjunctivitis and damage to the optic nerve. The eyelids are swollen.
2. Central nervous system. Anxiety conditions arise, and sleep disturbances (insomnia) may occur. Dizziness and headaches.
3. Metabolic processes of the body. Disturbances in carbohydrate metabolism are observed, and the risk of diabetes mellitus increases.
4. The cardiovascular system. Heart rhythm disturbances occur and blood pressure readings are elevated. Attacks of heart pain may occur.
5. Endocrine system. The process of hormone production by the adrenal glands is suppressed, and dysfunction of the gonads is observed (impotence, infertility, disruption of the ovulatory cycle).
6. Digestive system. There is increased gastrointestinal motility (diarrhea), nausea. Gagging and vomiting are rare. Rarely, fatty liver occurs.

As the disease progresses, the thyroid gland gradually enlarges, it becomes denser, but pain does not occur on palpation.

Diagnosis

Given the existing manifestations characteristic of Graves' disease, it is easy to identify toxicity.

However, the final diagnosis of Graves' disease is made through the following medical procedures:

1. Interviewing the patient and assessing his subjective feelings.
2. Visual inspection of the glandular organ combined with its palpation.
3. If palpation is not possible, radioisotope scanning is recommended.
4. Ultrasound examination of the thyroid gland.
5. Laboratory study of the concentration of thyroid hormones in the blood (thyroid hormones). At the same time, triiodothyronine and thyroxine are elevated, thyroid-stimulating hormone is reduced.
6. A study is being conducted of the thyroid gland's reaction to radioactive iodine - in case of pathology, the organ intensively absorbs iodine.

After all the necessary research and approval of the preliminary diagnosis, the medical specialist has the opportunity to prescribe the optimal treatment for Graves' disease.

Treatment

A specific treatment method that would be used universally for diffuse toxic goiter has not been developed.

However, there are several methods that are effective depending on the course of the pathology and its severity. The main methods are:

• drug therapy;
• surgical intervention;
• use of radioactive iodine.

The most common is drug therapy.

Drug therapy

Drug treatment involves the use of thyreostatic drugs that suppress the excessive activity of the glandular organ.

• Thiamazole;
• Carbimazole;

During therapy, constant monitoring of thyroid hormone concentrations in the blood is required. This control is carried out until any manifestations of the disease disappear completely.

The estimated period during which the manifestations disappear is 1 year or more. In addition to thyreostatics, the following groups of medications are used:

• immunocorrectors;
• glucocorticoids;
• beta blockers.

In order to increase the effectiveness of drug therapy, the patient should exclude foods that have a high iodine content (especially iodized salt), and also avoid sunbathing.

When, after a certain period, there is no positive dynamics from the use of drug therapy, surgical intervention is indicated.

Surgery

Surgical procedures are indicated in the case of an overly enlarged thyroid gland. That is, when the goiter begins to put pressure on the esophagus or trachea, squeezing them strongly.

Also, an indication for excision of thyroid tissue is prolapse of the glandular organ behind the sternum or atrial fibrillation has occurred due to Graves' disease.

With Graves' disease, depending on the degree of its severity, partial or complete removal of the glandular organ can be performed.

However, with partial removal of the thyroid gland, the cause of the dysfunction of the organ cannot be eliminated.

Treatment with radioactive iodine

Sometimes, when drug therapy is ineffective or the positive dynamics are too small, it can be used.

For patients of reproductive age, this method of therapy is undesirable, as it leads to sexual dysfunction.

When radioactive iodine enters the body, it damages the cellular structure of the glandular organ and thereby achieves the effect of reducing the activity of the thyroid gland.

Possible complications

The most severe complication that can occur due to Graves' disease is.

This condition is life-threatening for the patient. It is characterized by the following manifestations:

1. Excessive causeless irritability appears.
2. Vomiting occurs.
3. High blood pressure.
4. A sharp jump in body temperature up to 41°.
5. Increased contraction frequency of the heart muscle.
6. Coma may develop.

With a similar complication of Graves' disease, the following organs and systems are poisoned by thyroid hormones:

• cardiovascular;
• nervous;
• adrenal glands;
• liver.

If such disorders occur, hospitalization is required, since otherwise there is a high probability of death.

Thyrotoxic crisis develops rapidly and occurs suddenly. It can be triggered by the following factors:

• psycho-emotional stress;
• excessive physical activity;
• infectious diseases;
• heart attack;
• surgical interventions;
• radioactive iodine therapy;
• abrupt withdrawal of thyrostatics.

In addition, an excessive dose of synthetic thyroid hormones taken after removal of part of the organ can provoke the occurrence of a thyrotoxic crisis.

Forecast

Graves' disease does not have a very favorable prognosis. When a mild, erased form of the disease is observed, the pathology can be asymptomatic for decades.

In the acute course of the disease, death is possible. According to statistics, in the acute form the mortality rate reaches 30%. The main causes of mortality are the following:

• exhaustion from vomiting;
• exhaustion from diarrhea;
• heart failure;
• fever and others.

However, for the most part, the pathology has a benign course, although there is a slight decrease in the patient’s activity.

Preventive measures

Prevention of Graves' disease is aimed at eliminating factors that can trigger its onset. With a high probability, the following timely measures can prevent diffuse toxic goiter:

1. Elimination psycho-emotional stress and factors contributing to their occurrence.
2. Timely and correct treatment infectious diseases.
3. Refusal from alcohol-containing drinks, tobacco smoking, narcotic substances. Limit caffeine- and taurine-containing drinks.
4. Observe precautions when taking potassium iodide;
5. Reconsider your own eating habits and preferences, enrich diet with healthy and natural products.
6. Do regular moderate physical activity is habitual.
7. In a timely manner seek medical help and follow the recommendations of your healthcare professional.

Measures aimed at excluding relapses of the disease are usually considered refusal from sunbathing and swimming in the sea.

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Treatment of Graves' disease

Causes of Graves' disease

Treatment of Graves' disease with traditional methods

Treatment of Graves' disease traditional methods are ineffective because they do not have a mechanism for normalizing hormone production and can pose a danger to the health and life of the patient.

Treatment of Graves' disease during pregnancy

When pregnancy occurs against the background of Graves' disease, it is recommended to carry out monotherapy - thyreostatic drugs are prescribed in the minimum dose necessary to maintain the T4 concentration in the upper limit of normal or slightly higher. The drug of choice most often becomes propylthiouracil, which has poorer permeability through the placenta. Before prescribing thyreostatics, it is necessary to conduct a general blood test and determine the activity of γ-GTP and ALT. The first control study of thyroid function after the administration of thionamides and until a euthyroid state is achieved is carried out every 2 weeks, then every 6-12 weeks until the end of thyreostatic therapy.

The German scientist Karl Adolf von Basedow in the 19th century, based on similar signs, identified a severe thyroid disease in four of his patients, indicating its symptoms.

This disease was named Basedova. In modern practice, it is more often called diffuse toxic goiter.

And in some countries, the disease bears the name of the Irish doctor Graves, who, like Bazedov, made a description of the symptoms of the disease in the 19th century.

Graves' disease is a form of thyrotoxicosis. In this disease, the thyroid gland produces thyroid hormones in excess. For the normal functioning of all body systems, much less is required. The gland itself greatly increases in size. Among patients with this diagnosis, the majority are girls and women under 45 years of age. In older people, goiter is diagnosed very rarely.

In a person suffering from Graves' disease, the immune system mistakes the cells of his body for enemies and fights against them. Antibody proteins are actively produced, which accelerate the synthesis of thyroid hormones.

Diffuse toxic goiter is a consequence of a combination of certain internal factors with negative environmental factors. The immune response, to which a person has a genetic predisposition, appears due to exposure to external stimuli.

Graves' disease is an endocrine disease that is caused by more than one factor.

Graves' disease occurs in the following conditions:

• psychological trauma, stressful situations, emotional stress;
• diseases caused by pathogens entering the body;
• colds of the nose and throat;
• head injuries;
• smoking, including passive smoking, drinking alcohol.

However, until now, indications of the causes of Graves' disease are only assumptions. The etiology of the disease is still an open question.

The mechanism of development of the disease is as follows. AT-rTSH - antibodies to the thyroid-stimulating hormone receptor (TSH) are formed. They activate this receptor, triggering cascades of enzymatic reactions inside cells.

The reactions enhance the process of iodine uptake by thyroid cells, which causes the release of a large amount of thyroid hormones and intensive division of thyroid epithelial cells (thyrocytes). As a result, symptoms of thyrotoxicosis are observed, which are the main clinical manifestations of diffuse toxic goiter.

Signs

Thyrotoxicosis is manifested by the following symptoms (we will designate them in development, from the very beginning of the disease to its severe degree):

• mood instability;
• increased sweating;
• tremor of fingers;
• causeless loss of up to 10 percent of weight;
• the heart beats at a rate of more than 100 beats per minute;
• sleep disturbance;
• causeless restlessness;
• neurasthenic;
• disruptions in the menstrual cycle;
• decreased sex drive;
• problems with potency;
• strong feeling of stuffiness;
• a person loses more than 10 percent of his weight;
• pulse per minute – from 120 beats;
• performance is impaired;
• inability to concentrate or remember anything;
• tearfulness;
• trembling of the whole body.

Signs of inflammation of the thyroid gland of an autoimmune nature, which the doctor notices during the examination:

• A loud noise is heard above the gland using a phonendoscope (the inflamed organ is supplied with blood more intensely than a healthy one);
• when palpating the thyroid gland, the doctor identifies the isthmus of the organ by touch;
• ophthalmopathy is observed (in 95 percent of all cases of diffuse toxic goiter);
• on the legs - pretibial myxedema (in 10 percent of cases of Graves' disease).

Signs of ophthalmopathy (from mild to severe):

• eyes shine;
• the patient cannot completely close his eyelids, because the fatty tissue of the eyes is swollen.
• inflammation of the mucous membrane of the eyes;
• exophthalmos, i.e. “bulging” of the eyeballs;
• atrophy of the eye muscles.

Signs of pretibial myxedema are swelling and redness of the skin on the legs, itching.

Signs that the goiter is compressing surrounding tissues:

• dry cough;
• dyspnea;
• swelling and redness of the face;
• difficulty swallowing food.

Thyroid dysfunction can lead to the development of such a dangerous disease as we will discuss on our website.

Treatment methods for diffuse toxic goiter are reviewed.

No one is immune from Graves' disease, but preventing the disease will reduce the chances of a dangerous pathology occurring. Follow the link to read in detail about preventive measures.

Symptoms

The symptoms of Graves' disease are not the same at different stages of the disease. In addition to changes that are noticeable visually (movement of the eyeballs forward, thickening of the neck), many internal pathological changes occur in the body. Their symptoms are individual.

At first, the development of diffuse toxic goiter is latent, that is, it is not noticeable either to others or to the patient himself.

However, already at this stage one can suspect Basedow’s disease based on some features of the person’s behavior and condition:

• behavior instantly changes from aggressive to apathetic;
• profuse sweating;
• the hands are shaky;

In the acute stage of the disease, the following symptoms appear:

• The size of the thyroid gland is large, the goiter becomes visually noticeable, especially when a person swallows food;
• constant feeling of hunger;
• large loss of body weight;
• “bulging” eyes, shiny eyes;
• poor eyesight;
• swelling of the eyelids;
• if the patient looks down, strips of white sclera are visible above the corneas;
• headache;
• insomnia;
• frequent loose stools;
• abdominal pain that gets worse after eating;
• tachycardia;
• hypertension;
• a violation of fat metabolism, in which the absorption of carbohydrates in the body deteriorates (the onset of diabetes mellitus);
• disruptions in the reproductive system (menstrual cycle disorders in women, decreased potency in men).

Exophthalmos

Changes in the body at an advanced stage of the disease:

• the patient blinks very rarely;
• the eyeballs are strongly pushed forward;
• blindness;
• loss of teeth;
• impotence in men, early cessation of menstruation in women;
• ischemia;
• destruction of nails;
• swelling of the legs;
• dystrophy of internal organs.

A dangerous complication of Graves' disease is thyrotoxic crisis. Its symptoms:

• the patient's body temperature exceeds 40 °C;
• severe and sharp pain in the head;
• incoherence of speech;
• hallucinations;
• fear, anxiety for no reason;
• increased physical activity is quickly replaced by an apathetic, lethargic state;
• psychoses;
• frequent loose stools;
• vomit;
• abdominal pain;
• loss of consciousness or coma is possible.

Thyrotoxic crisis can be caused by sudden cessation of treatment with thyroid-stimulating blockers.

Diagnosis of diffuse toxic goiter

If the disease has entered the second stage of development, its symptoms are clearly expressed, and there are no difficulties with diagnosing Basedow’s disease. It is possible to identify the disease at the very beginning of its development only through research conducted in laboratory conditions.

With Graves' disease, the level of thyroid hormones in the blood is increased, and thyroid-stimulating hormones are decreased. In most cases, the test shows that there is more T3 in the blood than T4.

But in some cases of the disease with high T3, the thyroxine level remains normal.

If the increase in T3 and T4 is small, but the doctor suspects thyrotoxicosis, TRH is prescribed, i.e., the administration of rifathiroin, a drug containing thyrotropin-releasing hormone.

If TSH does not increase, this confirms that the patient has Graves' disease.

In medical practice, there were cases when, with elevated levels of T3 and T4, an increased level of thyroid-stimulating hormones was also observed. This was due to the fact that hyperthyroidism was caused by a pituitary adenoma that produces TSH.

Immunofluorescence diagnostics reveals 4 types of antithyroid antibodies in the blood. These antibodies are markers of thyroid pathology.

The biological method reveals how active thyroid-stimulating immunoglobulins (TSIs) are. If the TSI level does not decrease after drug therapy, the patient is prescribed surgical treatment.

Radioisotope diagnostics, once popular, are now rarely used because hormone levels can be measured. The basis of the radioisotope method is the ability of the thyroid gland to absorb iodine. 131I is introduced into the body, after 2 hours the rate at which it is absorbed by the gland is measured, after a day - the amount of iodine accumulated by the organ, after three days - the rate of decline.

Goiter on ultrasound

Hyperthyroidism is indicated by the absorption of iodine by the gland above 13% 2 hours after its administration, and accumulation after 24 hours normally should not exceed 34%. Scintigraphy of the thyroid gland makes it possible to find out the size of the organ, its shape, determine whether there are nodes, etc. The study identifies areas of tissue that capture isotopes.

Ultrasound. The echogenicity of the gland and its volume are determined. In Graves' disease, the echogenicity of the thyroid gland is reduced.

If a patient has many chronic diseases or there are malfunctions in only one system (gastrointestinal tract or cardiovascular system), it can be very difficult to differentiate Graves' disease. We need an integrated approach to diagnosis: taking into account symptoms and the results of all studies.

Treatment

Operation

Surgery is performed when the goiter becomes very large and puts pressure on the trachea or esophagus.

Surgery is also indicated if the overgrown thyroid gland has descended behind the sternum, if Graves' disease is complicated by atrial fibrillation, or if drug treatment is ineffective.

Drug treatment

Drug therapy is prescribed at all stages of goiter development.

Cytostatics play the main role in drug treatment.

These include “Merkazolil”. The maximum dose of medication per day should not exceed 60 milligrams, and at the initial stage of the disease - 30 milligrams.

After some time, the patient is transferred to the minimum daily dose of Mercazolil (2.5 milligrams), which he must take every day for a year. The drug can be discontinued by the attending physician after 6 months if there have been no exacerbations of the disease during this period.

Medicines containing iodine are prescribed by an endocrinologist only for individual indications. Potassium chlorate is usually used, which prevents iodine from entering the thyroid gland.

With complex therapy, it is possible to prescribe drugs that block beta-adrenergic receptors (Anaprilin, Obzidan, etc.). They normalize heart function. Medicines with corticosteroids are used, for example, Prednisolone, Hydrocortisone.

If the body is severely depleted, it is supported by anabolic agents with steroids.

Radioactive iodine

Thus, despite hyperstimulation by antibodies, the organ cannot produce hormones in excess.

After such treatment, the patient must take the hormones that the thyroid gland synthesizes for the rest of his life, since the normal functionality of the gland cannot be restored after radioactive therapy.

The proliferation of thyroid tissue of the thyroid gland provokes a condition such as. If you notice the symptoms of a pathological process in time, you can avoid a dangerous pathology.

Graves' disease is fraught with dangerous complications. You can read about the prognosis of Basedow's disease.

Folk remedies

The effect of traditional medicine is possible at the first stage of development of Graves' disease. You should consult your doctor about using an alternative treatment method.

Popularly, thickening of the neck is treated with infusions, the recipes for which are written below:

• Thyme infusion. The potion is prepared as follows: a tablespoon of dry thyme is brewed with boiling water in a volume of 200 ml. Close the pan tightly and wait 20 minutes until the plant releases its beneficial properties to the water. After straining, drink the infusion three times a day.
• Herbal tea to strengthen the body. Make a mixture of approximately equal amounts of motherwort, peppermint leaves, valerian roots and 2 tablespoons of hawthorn berries. A tablespoon of the mixture is brewed with boiling water and filtered after 30 minutes. The infusion should be drunk half a glass twice a day before meals. The course is 30 days, then rest is 10 days, and again a month of treatment.

The simplest method of treating Graves' disease is irradiation of the thyroid gland with radioactive iodine: the patient drinks water with a very small amount of this substance added to it, and the healing process begins.

However, such therapy is not indicated for everyone. For example, it cannot be performed on pregnant women: iodine will enter the baby’s body.

The method of treatment is selected by the doctor individually in each specific case of the disease.

Important conditions for recovery for any degree of development of diffuse toxic goiter are a calm environment, the patient’s confidence that he will recover, proper nutrition with a predominance of dairy products.

Video on the topic

Graves' disease– these are the consequences of improper functioning of the thyroid gland and hormonal imbalance in the body.

The exact causes of this disease and symptoms have not yet been fully established; it is only known that it belongs to the category autoimmune diseases and it most often affects females under the age of 45.

Graves' disease, its symptoms and causes are often referred to as Graves' disease or diffuse toxic goiter.

Causes

Graves' disease refers to diseases of the endocrine system and, accordingly, its occurrence is directly related to disturbances in the functioning of this system.

In addition, among the possible causes of Graves' disease are:

• Cause of Graves' disease in the presence of autoimmune processes and diseases in the human body. Autoimmune diseases are defects of the immune system when the body produces substances that have a detrimental effect on its own cells. With Graves' disease, the same thing happens: lymphocytes produce an abnormal protein, which causes the thyroid gland to produce excessive amounts of thyroid hormones.
• Cause of Graves' disease in infectious processes of a chronic nature in the body. Due to such foci, the number of lymphocytes increases, and they affect the functioning of the thyroid gland in the same way as described in the first case. In connection with this fact, Graves' disease often develops in humans against the background of diseases such as diabetes mellitus, chronic tonsillitis, vitiligo, hypoparathyroidism and others.

• Cause of Graves' disease in a viral infection.
• Cause of Graves' disease in the use of radioactive iodine to conduct any examinations may negatively affect the activity of the thyroid gland.
• Cause of Graves' disease in hereditary predisposition the same diseases.
• Cause of Graves' disease in mental disorders. Also, emotional disorders and constant nervous shocks in the body lead to frequent surges of adrenaline, which does not have the best effect on the endocrine system as a whole. In medicine, the causes of the development of Graves' disease in absolutely healthy people were observed due to severe shock or stress.

The above reasons are, rather, assumptions about Graves’ disease. In most patients with Graves' disease, the cause of its occurrence cannot be reliably determined. It can be noted that one proven fact still exists - The acute form of Graves' disease occurs due to mental or emotional stress.

The fact that women are more susceptible to Graves' disease is explained by the fact that the fairer sex has a more developed hormonal system and it is also most susceptible to various stresses (pregnancy, menopause, etc.)

Excess body weight– the cause is the occurrence of Graves’ disease. The greater the weight, the greater the load on the body as a whole and on its individual systems. This condition of Graves' disease is especially dangerous when the pancreas cannot cope with the production of special enzymes. In this case, the extraction of microelements from food and their absorption is significantly limited, and the body begins to experience a lack of them.

Symptoms

The onset of Graves' disease does not manifest itself as anything special. Therefore, a person may not even suspect that he is sick at first.

The primary symptoms of Graves' disease include:

• Symptoms of frequent mood swings and sleep disorders;
• Symptom of increased sweating in Graves' disease;
• Symptoms of fussiness of movements and tremors of the limbs;
• Symptom of increased heart rate.
• Thickening of the thyroid gland without pain.
• Usually there is a decrease in a person’s weight, but on the contrary, there may be a sharp increase in weight.
• A symptom of darkening of the skin to darker shades with Graves' disease.
• The occurrence of dense edema in the lower extremities.

• From the gastrointestinal tract the following symptoms are observed: diarrhea,
  nausea and vomiting, liver problems.
• Nails become brittle and brittle, they peel off and become yellowish. Hair becomes very thin, breaks and falls out profusely.
• In the sexual sphere Negative signs such as decreased libido, disruptions in the menstrual cycle in women, and inability to conceive are noticeable. Men may experience impotence. Such symptoms are associated with low production of hormones by the adrenal cortex.

Degrees of the disease

Main degrees of Graves' disease:

Diagnosis and consequences of the disease

Making an accurate diagnosis of Graves' disease in this case is not too difficult. The doctor is quite capable of determining the presence of this autoimmune disease by the patient’s appearance and his characteristic behavior. However, to clarify the diagnosis of Graves’ disease and the causes of its occurrence, a number of measures are carried out:

• A blood test is required. If it contains an increased amount of iodine, triiodothyronine and thyroxine, then this confirms the presence of Graves' disease. The concentration of cholesterol in the blood is significantly reduced in this case.
• Radioisotope scan of the thyroid gland carried out to determine its exact dimensions and location. This study is necessary because it is necessary to exclude the presence of tumors in the thyroid gland and other diseases in it.
• Ultrasonography The thyroid gland is also indicated for diagnostic purposes of Graves' disease.

The consequences of Graves' disease are quite complex. As the disease progresses, the thyroid gland increases in size, which leads to significant thickening of the neck. This is visible even to the naked eye to any person. Sometimes it can grow so much that it looks like a tumor formation

Thyrotoxic crisis - This is one of the most severe consequences of Graves' disease. It occurs due to a huge release of thyroid hormones and poisoning of the body with them. A crisis is dangerous because of its suddenness and, in the absence of emergency medical care, can even lead to the death of the patient. A crisis of Graves' disease can occur due to the following reasons:

• Causes of severe mental or physical stress, stressful situation;
• The cause is a heart attack;
• Due to extensive inflammation in the body;
• Due to abrupt withdrawal of thyroid-stimulating drugs.

Treatment

The method of treating the symptoms of Graves' disease is determined only by the attending physician. This will depend on the causes, symptoms, degree of disease, size of the goiter, age group of the patient, the need to preserve reproductive function (for women), and the possibility of surgical intervention.

As a rule, treatment of the symptoms of Graves' disease is carried out either with medication or surgery.

Drug therapy is aimed at reducing thyroid production. Treatment of symptoms of Graves' disease differs in its duration: even if the symptoms smooth out after 2-3 months of treatment, treatment should be continued from six months to two years. If surgery is still indicated, then in its process part of the thyroid gland will be removed. This is also done to reduce the production of hormones in Graves' disease. But this method cannot eliminate the very cause of the disease.

Treatment of symptoms of Graves' disease is also indicated during the patient's pregnancy: in this case, of course, the dosage of prescribed medications will be significantly reduced. The same applies to the period of breastfeeding. Naturally, the woman must be under constant medical supervision..

A method like one-time oral administration of radioactive iodine has been widely used in the treatment of Graves' disease. The disadvantage of this treatment for Graves' disease is that it is suitable only for those patients who are no longer interested in preserving reproductive function.