Ten times as many women as men are diagnosed with Graves disease, an autoimmune disorder that causes thyroid hyperactivity. Most woman are diagnosed by the age of 40. So the fact that I have just been diagnosed with the disease makes me feel that maybe I’m not really as old as the calendar indicates. Those Scandinavian genes that give me hope that I will live to a very old age seem to be aging me at a slower pace. And that’s not bad.
At my annual consultation last fall, my doctor noticed that my thyroid is not in balance. A routine blood test indicated something was not right, but after a few more tests all that seemed clear was that the two halves of my thyroid, the butterfly-shaped gland at the base of the throat, were not producing at the same rate. Either one half is producing too little or the other is producing too much. He was concerned because a consequence of an overactive thyroid is atrial fibrillation, very rapid heart rate. We already spent a lot of time over the past year talking about my heart.
He referred me to an endocrinologist which led to more blood tests. And last week I got the call with the results. Antibodies in my blood indicate the early stages of Graves disease. This autoimmune disease, likely hereditary, causes my immune system to produce antibodies that act like the thyroid stimulating hormone (TSH) produced by the pituitary gland to stimulate thyroid to produce the hormones needed to regulate metabolism and other systems, including mood.
It seems my immune system is causing at least one half of my thyroid to overproduce. That’s hyperthyroidism. But I don’t have any symptoms of hyperthyroidism. Here they are, from Women’s Health.gov:
- Goiter (enlarged thyroid) (nope, not here);
- Trouble sleeping (anyone who knows my family knows that trouble sleeping isn’t a problem for any of us);
- Irritability or nervousness (well, maybe this one applies, although my dysthymia medication may be hiding it);
- Heat sensitivity, increased sweating (nope, not here);
- Hand tremors (the endocrinologist really tried to make this one happen, but the paper she placed on the back of my outstretched my hand sat there just as still as it could be);
- Rapid heartbeat (fixed with the EP study and ablation of the superfluous electrical signal triggering rapid heartbeat);
- Thinning of skin or fine, brittle hair;
- Frequent bowel movements (ahem, you’ll get no admissions from me about this)
- Weight loss without dieting (seems more like I suffer from weight gain without eating);
- Fatigue or muscle weakness.
Now as autoimmune diseases go, Graves disease seems relatively benign and easy to treat when diagnosed early. At the extreme, the thyroid can be removed or at least stunned into a nonfunctioning state, followed by taking supplements. At the most modest end, taking beta-blockers for a period of time addresses the symptoms and can even knock some sense into the thyroid and get it back on track again. If that doesn’t work, there are other medications that can prevent the production of TSH.
After talking it over with my endocrinologist, I decided to wait another three months before deciding to take any action. In my case, since I have no symptoms, beta-blockers aren’t an option. The endocrinologist prefers to treat the thyroid with radioactive iodine. But right now the over-activity isn’t enough to expect the thyroid to absorb the radioactive iodine. And taking anti-thyroid medication may slow the thyroid activity, but it will likely delay even further the timing for trying the radioactive iodine option. So I decided to give it three more months, then redo the blood tests to see if the over-activity has reached a point when it can be treated, not just hidden.
And since the source of the extra cardiac signal that caused my supra ventricular tachycardia has been fixed, the biggest risk my endocrinologist says I need to worry about now is bone density loss. So I will continue to take calcium and even more Vitamin D instead of adding anti-thyroid medication to my daily regime. Three months from now, I’ll have more information.
Because most cases of Graves disease are diagnosed in women, an excellent source of information is the Office on Women’s Health, U.S. Department of Health and Human Services website and so much of the information there relates to the possible complications during pregnancy. Check it out
Other sources of information: