Diagnosed with Grave’s Disease: Symptoms, Treatment
Hi! I have recently been diagnosed with Grave’s Disease, a kind of Hyperthyroidism. Its an autoimmune disease that affects the thyroid, is potentially fatal, and has a variety of psychological effects that are indistinguishable from a variety of mental health disorders (despite not being a psychiatric problem itself).
Hyperthyroidism is a very rare disease; only 1.2% of people in the United States suffer from it, and it affects women seven times as often as men, and usually starts appearing in the third or fourth decade of life. This demographic is why it's believed I went undiagnosed by so many doctors for so long, despite evidence that I may have had the illness as far back as my childhood (I’m a 21 year old cisgendered male)
^ WebMD’s Hyperthyroidism page is under Women’s Health
Hyperthyroidism refers to an overactive Thyroid (literally a Thyroid that is hyper), an organ located in the neck that’s responsible for metabolism, proteins, and several hormones, the Thyroid Hormones. These are the triiodothyronine (T3) and thyroxine/tetraiodothyronine (T4), and it is controlled by the Thyroid-stimulating hormone (TSH). The less TSH you have, the more T3 and T4 your thyroid produces.
^ Thyroid organ from http://womenshealth.gov/
When you are Hyperthyroid, a blood test will reveal these chemicals (and others) to be off the charts. As an example, here are my results from July from when it was first suspected and tested;
^ My thyroid tests! (TSH, FT4, FT3)
As can be seen, when a healthy person’s TSH is within the range of 0.40 and 4.00 (0.40 - 4.00), mine is less than 0.05. My free T3 (FT3) levels at 12.9, are almost twice as high as the upper limit of the healthy range (2.8-6.8), while my free T4 (FT4) levels at 40 are twice the upper limit of the normal human range (10-20).
This all translates to a variety of problems. The first and foremost is a very high and irregular heart beat - your body is on overdrive, almost constantly, resulting in atrial fibrillation and palpitations.
^ My ECG!
This alone is a very dangerous situation, increasing the chance of a variety of fatal heart events. More benignly, it leads to a general feeling of tiredness, nausea, and difficulties breathing. By the time my hyperthyroidism was discovered, I had fainted at least four times at random occasions across the past year alone.
Those fainting episodes were cardiac related events, as the overbeating heart was draining away my energy, and they coincided with a sense of breathlessness.
There are other physical manifestations. Since your body is on overdrive, so is your metabolism, which meant I lost weight despite indulging in the worst of dietary choices.
My hand also has a slight tremor to it, which was the first known indication by my discovering doctor that I had Grave's (he told me to extend my hand, and then placed a brochure on top of it, to better notice the shakes).
A body that is working too hard is also one that is running hot; as a kid they used to call me "Anak Kutub" or, Polar Kid, for constantly feeling hot, and a strange preference for air conditioned and cold environments.
Despite having lived the first fourteen years of my life in tropical, over polluted, over populated Jakarta, Indonesia, I could easily stroll through subzero frozen downtown Toronto in thin pants and coat.
The symptoms I've described are the ones that I have observed myself having - Grave's disease materializes differently for other people (for example, a symptom not displayed with me include bulging eyes and osteoporosis).
Symptoms may also advance with time. It is believed that I may have had hyperthyroidism for a huge chunk of my life (perhaps from childhood), but that it had been getting worse, precipitating with fainting episodes only in the last year or so.
Symptoms can also come and go; while a hyperthyroid constantly has thyroid levels exceeding healthy ranges, there are fluctuations in those levels which change the severity of symptoms with it. Sometime last week my heart beat was a mere 70 beats per minute (bpm) - today it rose up yet again to 96 bpm. When I was diagnosed, my heart beat exceeded 100 bpm (which is considered Tachycardia).
But if a hyperthyroid hypes to its max, then an event called a Thyroid Storm may occur.
A Thyroid Storm can lead to coma and/or death. It occurs when the thyroid gland produces critical levels of hormones, resulting in dangerous blood pressure levels, very high fevers, vomiting, sleepiness, yellowing skin, and of course very high and irregular heartbeats.
But in addition to the physical symptoms of Hyperthyroidism, there are also a slew of psychological symptoms that come with it; the condition merely mimics mental health issues.
Grave’s disease has been mistaken for everything from anxiety disorder to every variant of bipolar disease. This is because the atypical thyroid person of the hyperthyroidism kind may experience depression, mood swings, anxiety, irritability, paranoia, racing thoughts, derealization, aggressive feelings, and a variety of other psychological issues so long as their thyroid remains out of control (or remains not surgically removed).
I must admit that I have experienced all these symptoms, particularly after my first fainting incident sometime in early 2014. Before the test revealed my overactive thyroid, I was initially diagnosed with anxiety disorder, and given related medication. I believe though that with the progress made under my current treatment plan, they are now better managed.
Its important to note however, that Hyperthyroidism is not a mental health disorder - it doesn’t fall under psychiatry, and is treated under the realm of endocrinology.
To that end, my psychiatrist has even turned me away upon the discovery of my hyperthyroidism - wishing me well with my thyroid, and remarking that I could return if I wished in the future, once my hyperthyroidism had been managed to normal human levels, and if I continued to exhibit signs of psychiatric issues after my thyroid treatment.
There are a variety of options for treatment. Right now I am on a drug plan being treated with Thyrozol (ingredient name: Thiamazole) an anti-thyroid drug, some beta blockers and sometimes other heart medication to manage my palpitations and high beats, and occasional other stuff that relates to symptom mitigation.
Every few weeks, I get a blood test that measures my thyroid levels, to see how much progress the drug plan is. So far my results have been good; the plan will take 12 to 18 months to reach normal hormone levels, after which I will take different medication to simply maintain the thyroid levels.
^ My blood!
If this fails however (a remission of thyroid overactivity is detected) there are further options in the form of radiation therapy, and thyroidectomy (surgical removal of the organ), or a combination of both.
^ Thyroidectomy variations
Though I was at risk of some sort of fatal cardiac related event after my last few episodes of fainting, the heart medication I am currently taking all but erases the risk of my death through any heart issues, subsequently also decreasing the chance of any fatal thyroid storms.
I am optimistic at the progress that has been made under the drug plan, and I yearn for its success. The prospect of being thyroid typical drives me forward, and I’d like to thank everyone for their concern, support, and well wishes in my journey towards medical soundness
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