Graves' Disease & TSH Levels Explained 

In the US, Graves' disease is considered to be among the common causes of hyperthyroidism. Graves' disease usually targets women who are 20 years old or older but it can affect both men and women and at any age.

If Graves' disease is left untreated, it can cause thyrotoxicosis and in severe cases, brittle and weak bones, heart issues, thyroid storm and even death. If Graves' disease is not properly treated, it might cause health issues for a baby or fetus like low birth weight, preterm birth, still birth and thyroid issues. It is important to determine Graves' disease TSH levels and seek treatment for this disease at an early stage to lower down thyroxine production and relieve the symptoms.

What Is Graves' Disease?

Graves' disease is a type of hyperthyroidism. It is an autoimmune disorder in which the thyroid gland starts producing extra thyroxine as it is being attacked by its own immune system.

How Do I Know If I Have Graves' Disease?

With Graves' disease, you will have some specific, annoying signs and symptoms. The following are some of the symptoms of Graves' disease:

  • Anxiety
  • Insomnia
  • Tremors in the fingers and hands
  • Enlargement of thyroid gland called Goiter
  • Tiredness
  • Irritability and moodiness
  • Brittle hair
  • Heat sensitivity
  • Increase in the frequency of bowel movements
  • Accelerated heart beat called Tachycardia
  • Changes in menstrual cycle
  • Irregular heart beat called Arrhythmia
  • Loss of weight even if the patient is eating properly  

What Causes Graves' Disease?

The malfunctioning of the body's immune system which is responsible for fighting off the diseases is the main cause for Graves' disease. However, the reason for this malfunction remains a mystery.

The production of antibodies for targeting bacterium, foreign substances and viruses is a normal immune system response. In Graves' disease, the immune system starts producing an antibody to the cells of thyroid, a hormone-producing gland located in the neck.

Regulation of the thyroid function is the duty of a hormone released by the pituitary gland which is a tiny gland located at the base of the brain. The antibody produced by the immune system in response to Graves' disease is called TRAb or thyrotropin receptor antibody. The TRAb acts in a similar manner as the pituitary hormone and can override the thyroid’s normal function, resulting in the over-productionof thyroid hormones. This condition is called hyperthyroidism.

The Available Graves' Disease Diagnosis 

Here are over 7 methods that can be used to test whether you have Graves disease or not:

1. Graves' Disease TSH Levels Test

The Graves disease TSH levels test is among the first test that the doctor orders when diagnosing this disease as he/she wants to check the level of your thyroid-stimulating hormone (TSH). TSH levels are usually very low in Graves' disease as the pituitary gland ceases the production of TSH in an attempt to compensate for the excess T3 and T4 hormones in the blood. 

2. Testing Total T3 and T4 Hormone Levels

The doctor will also want to check your T4 and T3 hormone levels to confirm the Graves' disease diagnosis. A blood test will be conducted to check for elevated T3 and T4 levels since in patients with Graves' disease the thyroid stimulating immunoglobulins or TSIs are causing the thyroid to produce excess T3 and T4 hormones.

3. Testing Free T4 Hormone Levels

If the Graves' disease TSH levels do not come out normal, then free T4 hormone test is conducted. It is an advanced diagnostic test that is more reliable than the total T4 test. It is not affected by body proteins and is therefore capable of providing a better picture of the thyroid dysfunction.

4. Testing Thyroid-Stimulating Immunoglobulin (TSI) Levels

Thyroid-stimulating Immunoglobulin is an antibody that can bind to tissue in the skin and beneath eyeballs, resulting in conditions like pretibial myxedema and exophthalmos. This test is only conducted if the doctor is sure that a diagnosis for Graves' disease can be confirmed from your other symptoms.

5. Testing Thyroid Peroxidase Antibodies (TPO) Level

This test is recommended because of the auto-immune nature of Graves' disease. In this test the thyroid Peroxidase antibodies are measured. If they are present in the body, it means that the immune system is attacking the thyroid gland. However, it is not a sure indication of an autoimmune disorder as they are found in the blood of 5%-10% healthy people too.

6. Radioactive Iodine Uptake (RAIU) and Scan

This test measures the amount of iodine that can be absorbed by your thyroid gland. It involves taking a radioactive tracer, an iodine "pill", around 4 to 6 hours before the first scan. The scan is repeated after 24 hours. The amount of radioactive tracer will be the determining factor: If you have a high uptake of iodine tracer, it means that you have Graves' disease.

7. Other Tests

Other than Graves' disease TSH levels test and other 5 test mentioned above, the doctor may order tests like CT scan, ultrasound, echography or MRI scans of the eye and the eye sockets to see if the Graves' disease is affecting your eyes and the surrounding muscles of the eyes.

How to Treat Graves' Disease

The following are some of the treatments options available for Graves' disease.

1. Medications

Antithyroid medicines are one of the treatment options recommended for Graves' disease. The two medications that are usually prescribed in the US are Propylthiouracil or PTU and Methimazole or MMI. These drugs stop the thyroid from producing excess thyroid hormones and can be used for up to two years.

2. Radioactive Iodine

Radioactive Iodine is a form of Iodine which destroys the cells of the thyroid gland through radiation, thereby stopping the over-production of thyroid hormones. It is taken in pill form and can be used for a long time without causing any harmful effects to other body parts. However, you will have to take thyroid hormone to compensate for the inadequate thyroid hormones production due to this procedure.

3. Surgery

Surgery is another treatment method for curing an overactive thyroid. It involves removal of part or all of the thyroid gland. It is useful for treating Graves' disease, but the patients have to take thyroid hormone to meet body's daily thyroid hormone requirement.