I first met with Monica and Rachel on a beautiful sunny day this October at their home in southeast Portland to talk to them about Rachel’s chronic illness, hyperthyroidism. Monica and Rachel have been a couple for about four years, but have been friends for over ten when they met through mutual friends in Los Angeles. They are by their own definition “middle-aged cosmopolitan lesbians” living a life together as a married couple without the legal title. It was Monica that realized something was wrong with Rachel’s thyroid in the fall of 2013 and they have worked together and with their healthcare providers to help manage and slow the progression of Rachel’s diagnosis of Graves’ disease. This paper will talk about Graves’ disease and how …show more content…
Karen Holt describes in her 2010 article Graves’ Disease: Clinical Pathophysiology, Presentation and Treatment Options of certain genetic markers that cause the blood vessels surrounding the thyroid gland to dilate, most often occurring in the second to third decade of life. The dilation of these vessels causes an increase in blood flow and thyroid-stimulating antibodies excite thyrotropin receptors on the gland itself in the same manner that TSH usually works. These antibodies, known as TSAb, bypass the negative feedback loop that TSH works under causing the follicles to produce thyroid hormones in copious amounts without the ability to turn themselves “off”. This in turn causes the thyroid gland to hypertrophy and grow as much as 2 to 3 times its normal size (p. 13-14). In an effort to stop the overproduction of thyroid hormones the pituitary gland will stop making TSH and this becomes part of the diagnosing for Graves’ disease when assessing hyperthyroidism. Increased levels of free T3 and T4 along with an almost non-detectable level of TSH in a blood screen are very indicative of Graves’ disease (Holt, 2010, p. 14). There is no cure for Graves’ disease, but it is treatable with lifestyle adjustments as well as drug therapy it can be managed to a point (p 46). In terms of the trajectory model put forth by Anselm Straus and Juliet Corbin (2013) Rachel
Graves ' disease is an immune system disorder that results in the overproduction of thyroid hormones (hyperthyroidism). The thyroid gland is an important organ of the endocrine system. The gland is located at the front of the neck above where the collarbones meet. This gland releases the hormones thyroxine (T4) and triiodothyronine (T3), which control body metabolism. Controlling metabolism is important for regulating mood, weight, and mental and physical energy levels. When the body makes too much thyroid hormone, the condition is called hyperthyroidism. Graves disease is the most common cause of hyperthyroidism and is most common in women over age 20. But the disorder can occur at any age and can affect men as well. Some of the symptoms of Graves diseases are
Graves’ disease was named after Robert J. Graves, MD, around the 1830’s. It is an autoimmune disease indicated by hyperthyroidism due to circulating autoantibodies, which is an antibody that attacks the person’s own body. The immune system attacks the thyroid gland, which causes it to produce too much thyroxine. Thyroxine is a hormone that helps control growth and also regulates metabolism in the body. While the thyroxine levels are high the patient’s metabolic rate increases, which can have an effect on their physical appearance as well as their frame of mind. Graves’ disease is the number one cause of hyperthyroidism in the U.S.
Hashimoto’s Thyroiditis, also called Hashimoto’s disease is an autoimmune disease in which the body’s immune system attacks the thyroid gland. It was named for the Japanese surgeon who discovered it in 1912 The thyroid is a small butterfly shaped gland in the front of the neck. The thyroid makes hormones called T3 and T4. These hormones regulate metabolism. The thyroid is controlled by hormones of the pituitary gland, which is also called the “master gland.” It is a pea-sized gland located in the base of the brain which, among others, makes thyroid stimulating hormone, or TSH. TSH stimulates the thyroid to make thyroid hormone. With Hashimoto’s disease, the thyroid cells are damaged resulting in the inability to make enough thyroid
TSH not only stimulates the thyroid gland to churn out more hormones. If in excess, can cause overwhelming cell growth and division to result in goiter.
Grave’s Disease is an autoimmune disease that affects the thyroid and its hormone production. Normally, a healthy immune system releases antibodies that are designed to attack bacteria and viruses. In addition to antibodies, the thyroid creates hormones that regulate overall hormone production. With Grave’s Disease, the immune system releases antibodies that imitate these thyroid hormones; this leads to overproduction of hormones, or hyperthyroidism. Doctors are not sure as to what exactly causes Grave’s disease, but it is speculated that factors such as age play a role; as in, younger people are typically more prone to this illness. Its symptoms include anxiety; sweating; heart
Thyrotoxicosis is a clinical condition caused by excess circulating serum thyroxine (T4), triiodothyronine (T3), or both with suppression of thyroid-stimulating hormone (TSH). A negative feedback loop involving the hypothalamus, pituitary, and thyroid gland regulates the production and release of thyroid hormones. (Fig. 1) The hypothalamus releases thyroid-releasing hormone (TRH), stimulating the pituitary gland to release TSH, in turn stimulating the thyroid gland to release T4 and T3. Enhanced production of T4 and T3
Graves’ disease is an autoimmune disease that was discovered by Robert Graves in 1835. Graves’ disease is an autoimmune disease in which the body's immune system attacks the thyroid gland and causes hyperthyroidism. Graves’ disease occurs when the antibodies like thyroid-stimulating immunoglobulin and thyrotropin receptor antibodies (TRAbs) attack the thyroid gland as if it were a foreign object or a virus of some sort. This disease is the most common type of hyperthyroidism. Attacking
Grave’s disease is the most common form of hyperthyroidism, affecting more than seventy percent of people. This disease usually occurs when the immune system’s antibodies in the blood, also known as lymphocytes, attack the thyroid and bind to the surface of thyroid cells, which then grow in size and secrete too much thyroid hormone. It is thought to be a genetic disorder. Thyroid hormone plays a significant role in the body’s metabolic processes. When too much thyroid hormone is present, every bodily function tends to speed up. Common symptoms include nervousness, irritability, increased perspiration, heart racing, tremors, anxiety, difficulty sleeping, thinning of the skin, fine brittle hair, weakness of the muscles in the upper arms and thighs, frequent bowel movements, weight loss and for women, menstrual flow may lighten or occur less often. In Grave’s disease, the eyes may look enlarged or bulge. A goiter, or swelling in the front of the neck from an enlarged thyroid gland, is also common.
Grave’s disease is a disorder of the immune system causing the body to have an overproduction of hormones to the thyroid gland (hyperthyroidism). I chose this disease because I’ve known of a few people that have had difficulties with their thyroid’s. I wanted to learn more about it to be able to make other’s aware that they should have their thyroid checked regularly. The signs and symptoms that are associated with Grave’s Disease are anxiety, weight loss, puffy eyes, hand tremor’s, heat sensitivity, and the most noticeable is the enlargement of the thyroid. They can also experience insomnia, irritability and hair loss. Even though individual’s may have these signs and symptoms, this disease does require a medical diagnosis from a doctor.
This process originates in the hypothalamus when thyrotropin, otherwise known as TRH, is secreted and passes through the hypothalamic vein (Kapustin, 2010). Once the thyrotropin reaches the TRH receptors, they bind and make genes synthesize a thyroid stimulating hormone, otherwise known as TSH (Kapustin, 2010). When the pituitary makes mature TSH, thyroxin and triiodothyronine hormones are produced and secreted and implements a complicated negative feedback process that low levels of thyroxine and triiodothyronine cause TSH levels to rise and high levels of thyroxine and triiodothyronine cause levels of TSH to decrease (Huether & McCance, 2012). Not enough credit is given to this little thyroid gland on the front of the neck. The thyroid helps regulates powerful hormones that are required for growth and development as well as maintaining homeostasis. If we don’t have enough of the thyroid hormone, myxedema can occur. Myxedema can cause multiple organ complications that lead to serious illnesses. For example, with myxedema affecting the heart, complications such as pericardial effusion and bradycardia can occur and with myxedema affecting the reproductive organs, infertility can occur (Kapustin,
The reason I pick this disease is this is what my grandmother pass away from and is not in a better place. Graves disease which was first described by Robert Graves in the 19th century, this disease if one of the most common thyroid problems.It is also the leading cause of hyperthyroidism, a condition in which the thyroid gland produces excessive hormones. Once this disorder is diagnosed it is east to treat, in some cases the disease has gone into remission or disappeared completely after some months or years. if left untreated this disease can lead to many serious complications
The main cause of hyperthyroidism Graves’ disease which affects quite a few people in the general population. This disease is characterized as an autoimmune disorder. This means that the body makes antibodies known as thyroid stimulating immunoglobulin that bind and over activate the production of thyroid hormones [3]. So in essence the antibody mimics the thyroid stimulating hormone and when the negative feedback loop is in affect the antibody still binds to the thyroid and T3 and T4 are over produced [2].
When the Thyroid begins to produce too much of the Thyroid Hormones it can cause a condition called Hyperthyroidism. Hyperthyroidism has been found to have three main causes; Graves Disease (which Ava is currently suffering from), Toxic Multinodular Goiter and Toxic Adenoma (Felicilda-Reynaldo, Kenneally, 2016). Laboratory tests conducted on Ava have shown that her TSH (Thyroid Stimulating Hormone) is low whilst the Triidothyronine (T3) and Thyroxine (T4) levels are much higher. A diagnosis of graves disease is commonly confirmed by low levels of TSH and higher levels of T3 and T4 (Streetman, Khanderia, 2003). The cause behind low TSH (Thyroid Stimulating Hormone) is due to the decline in production based on a negative feedback response stemming from Antibodies binding to TSH receptors, causing the thyroid gland to release it own ‘Thyroid Hormone’ and in turn the haematological levels of ‘Thyroid Hormone’ increases. (Understanding Pathophysiology, 2012, p.258). This particular negative feedback then causes the TSH (Thyroid Stimulating Hormone) production to decrease. Whilst this is occurring those very same increased ‘Thyroid Hormone” levels in the blood begin to activate receptors located at the thyroid gland causing increasing levels
The physician usually will check the patient’s triiodothyronine (T3) thyroxine (T4) and thyroid-stimulating hormone (TSH) levels. The TSH is the most important of the three test in determining hyperthyroidism in patients. All patients with TSH stimulating hormone levels greater than 10 mIU/L should be treated for hyperthyroidism. It is when the TSH levels are less than 10 mIU/L that the patient signs and symptoms of hyperthyroidism should be considered in treatment. According to Drugs and Therapy Perspectives (2012), this is because although subclinical disease may progress to overt disease, and serum TSH levels greater than 10 mIU/L are associated with a decline in lipid profiles, there is insufficient evidence to demonstrate a link between adverse cardiac events, cardiac dysfunction, neuro-psychiatric symptoms or systemic hypothyroidism symptoms and TSH levels greater than or equal to 10 mIU/L. (p. 17) Nurses should evaluate the patients understanding of the test and the need for the testing not only for the diagnosis of hypothyroidism but for the continued treatment on the
One cause is a condition called diffuse toxic goiter (graves' disease), an autoimmune disease where the body manipulates the thyroid gland into overproducing thyroid hormones even if excess already exist. Individuals with Graves ’ disease have slow growth of the thyroid gland by the use of immunoglobulin to neutralize proteins such as, thyroid peroxides, thyroglobulin and thyroid stimulating hormone receptor. Graves’ disease is the first most common cause of hyperthyroidism (Parangi & Phitayakorn, 2011). Another cause is referred to as subacute thyroiditis. This occurs when an excess amount of thyroid hormone is discharged because of an infection of the thyroid or certain medications being consumed (Parangi & Phitayakorn,