Grave's Disease in story form
Grave's Disease is an autoimmune condition that affects the thyroid, making it hypER active. It produces too much hormone for your system, much like driving a car with the accelerator pedal stuck. The problem isn't with your thyroid exactly, it is with your immune system. Your thyroid is only doing what it is being told to do.
Antibodies can be difficult to understand, but they are very important to be familiar with if you have any kind of thyroid autoimmune disease. A dear friend emailed me a while back with a wonderful way to learn about the antibodies responsible for Grave's Disease. I wanted to share it with you... Now, stick with me. I know it's confusing at first, but it's really not so bad...
To prepare you for the story, here are some definitions:
TSH- Thyroid stimulating hormone (TSH) is produced by your pituitary gland inside your brain. It tells/stimulates your thyroid to turn ON. Think of it as a key, looking for a lock.
TSH receptor- This is inside the thyroid, eyes, skin, brain, and other tissues of the body. This is the part the antibodies are manipulating in Grave's disease. It is the lock. When a key fits into the lock the thyroid turns on and produces hormone. TSH receptors are sensitive to TSH from the pituitary as well as antibodies.
T4- one of the hormones made inside the thyroid. It is the storage hormone. Your body must turn it into T3 to be used.
T3- one of the hormones made inside the thyroid. It is the active hormone your cells can use. Your body's organs can use T4 to create T3 where it's needed, if everything is working correctly and you are properly nourished.
TRab- Grave's antibodies that can block or stimulate the gland. They pretend to be TSH but have a stubborn attitude.
TSI- Grave's antibody that stimulate the TSH receptor. Another term for stimulating TRab.
TPOabs- antibody to the inside parts of a thyroid cell
TGabs- antibody to the protein in thyroid tissue that binds with iodine to make thyroid hormone
I just came up with a way to explain these antibodies that might make it easier to comprehend. See if this makes sense....
Ok. Imagine a dairy farm full of cows in stalls. Those cows are actually TSH receptors - and they are waiting for the milkers (TSH) to come by and start milking (stimulating) them to produce milk (T4/T3).
In a normal setting, there is usually a set number of milkers and cows in the barn (TSH and its receptors). They are milking at a moderate pace and never cause any trouble........If milk flow gets too high, then they lay off a few workers (ie TSH goes lower). If milk flow goes too low, then they hire a few workers (TSH rises a little).
But one day, a large group of TEMPORARY WORKERS (TRab antibodies) come to the barn and decide THEY want to help. These temp workers push the regular workers off their stools and take over the milking part (TSI). But they go WAY overboard on the milking part, and start going crazy ---- milking wildly, every single cow, which produces WAY too much milk (T4/T3).
They measure the tank and find the milk is OVERFLOWING! The boss looks into the tank and says "THE CREW IS USING TOO MUCH STIMULATION!" (the TSI test)
Since there are plenty of TEMP WORKERS (TRab), and milk flow is high, the other regular workers go take a vacation. (TSH disappears).
But another problem often happens with this situation --- these TEMP WORKERS don't always continue to milk like mad. Some of them become LAZY (especially during Anti-Thyroid Drug therapy aka ATD), and instead of milking the cow, they'll just hold onto the udders and not pump any milk (blocking TRab). Some of the others are still going at it WILDLY, but because these lazy workers aren't performing, the "milk" production slows way down. (TSI levels drop).
Keep in mind ----- The NUMBER of workers (antibodies) is still the same, but the TSI (stimulation) is now LOWER than it was before - simply because these workers are not as effective as they were earlier. (Same situation may have occurred before they went crazy milking, and might have created a hypO situation similar to this, before Graves diagnosis).
As soon as the REGULAR workers (TSH) hear that the TEMP WORKERS aren't performing like they were, they come back from vacation (some are on LONG vacations though) and they try to PUSH these "Blockers" away from the cow, so they can hold the udders. But they can't!!! The Lazy workers (Blocking TRab) hold so tight that the REGULAR (TSH) workers can't get in there and get the milk (hormones) flowing again.
So this cow becomes a non-producer as long as that blocker stays there. (And this is where many endos who are not thyroid specialists confused this situation with HASHI's (Hashimoto's thyroiditis - autoimmune hypOthyroid disease), where they assume the cow has been destroyed. But the cow is NOT dead, it just is being "locked down", or squeezed by the blocking TRab.
This is why we call them "BLOCKING TRab" ---- they don't let anyone on the receptors (cows) and thus prevents stimulation.
If **MOST** of the TEMP workers are "LAZY" types (blocking), then the milk production will come to a HALT! Milk (T4/T3) will fall. This will cause the REGULAR workers to call all their friends (More TSH) to arrive and try to get those Blockers away from the cows!
There may be some fights that occur during all of this --- and a FEW cows might get killed during the battle.... This causes inflammation, cell destruction, and resulting antibodies against those cells themselves in the form of TPOabs, TGabs. But most of the cows will come out just fine unless the TEMP WORKERS bring their home boys (Lymphocytes- white blood cells) to rip the place up! That will down quite a few cows! And milk production will NEVER recover in that case....no matter how many Regular workers are on the job. (ie. Even with very high TSH).
Eventually -- as you get closer to remission - the ATD therapy plucks the TEMP WORKERS (TRab) off the receptors, one by one.....it might take years, but the barn won't be functioning properly UNTIL those TEMP WORKERS are no longer in control of the cows. As the TEMP workers go away, the REGULAR workers come back and take charge again.
Did that help any?
It's really confusing, but once you get the roles that each antibody plays, it makes it all MUCH more simpler to understand....Don't feel bad --- VERY FEW endos know about this unless thyroid is their specialty. That's because this research is all happening in Japan and a few European countries.
The US medical realm in general really don't CARE what these antibodies are doing, so they probably won' t be learning any of this...They feel thyroid ablation (destruction with radiation- the treatment of choice in the US) is all they need to know.... :(
So it will probably be up to those foreign research teams to tell us what these TEMP WORKERS (antibodies) are doing to those "COWS" we have located in our other tissues ---- brain, bones, skin, eyes, etc. That's all still unknown...
Antibodies can be difficult to understand, but they are very important to be familiar with if you have any kind of thyroid autoimmune disease. A dear friend emailed me a while back with a wonderful way to learn about the antibodies responsible for Grave's Disease. I wanted to share it with you... Now, stick with me. I know it's confusing at first, but it's really not so bad...
To prepare you for the story, here are some definitions:
TSH- Thyroid stimulating hormone (TSH) is produced by your pituitary gland inside your brain. It tells/stimulates your thyroid to turn ON. Think of it as a key, looking for a lock.
TSH receptor- This is inside the thyroid, eyes, skin, brain, and other tissues of the body. This is the part the antibodies are manipulating in Grave's disease. It is the lock. When a key fits into the lock the thyroid turns on and produces hormone. TSH receptors are sensitive to TSH from the pituitary as well as antibodies.
T4- one of the hormones made inside the thyroid. It is the storage hormone. Your body must turn it into T3 to be used.
T3- one of the hormones made inside the thyroid. It is the active hormone your cells can use. Your body's organs can use T4 to create T3 where it's needed, if everything is working correctly and you are properly nourished.
TRab- Grave's antibodies that can block or stimulate the gland. They pretend to be TSH but have a stubborn attitude.
TSI- Grave's antibody that stimulate the TSH receptor. Another term for stimulating TRab.
TPOabs- antibody to the inside parts of a thyroid cell
TGabs- antibody to the protein in thyroid tissue that binds with iodine to make thyroid hormone
I just came up with a way to explain these antibodies that might make it easier to comprehend. See if this makes sense....
Ok. Imagine a dairy farm full of cows in stalls. Those cows are actually TSH receptors - and they are waiting for the milkers (TSH) to come by and start milking (stimulating) them to produce milk (T4/T3).
In a normal setting, there is usually a set number of milkers and cows in the barn (TSH and its receptors). They are milking at a moderate pace and never cause any trouble........If milk flow gets too high, then they lay off a few workers (ie TSH goes lower). If milk flow goes too low, then they hire a few workers (TSH rises a little).
But one day, a large group of TEMPORARY WORKERS (TRab antibodies) come to the barn and decide THEY want to help. These temp workers push the regular workers off their stools and take over the milking part (TSI). But they go WAY overboard on the milking part, and start going crazy ---- milking wildly, every single cow, which produces WAY too much milk (T4/T3).
They measure the tank and find the milk is OVERFLOWING! The boss looks into the tank and says "THE CREW IS USING TOO MUCH STIMULATION!" (the TSI test)
Since there are plenty of TEMP WORKERS (TRab), and milk flow is high, the other regular workers go take a vacation. (TSH disappears).
But another problem often happens with this situation --- these TEMP WORKERS don't always continue to milk like mad. Some of them become LAZY (especially during Anti-Thyroid Drug therapy aka ATD), and instead of milking the cow, they'll just hold onto the udders and not pump any milk (blocking TRab). Some of the others are still going at it WILDLY, but because these lazy workers aren't performing, the "milk" production slows way down. (TSI levels drop).
Keep in mind ----- The NUMBER of workers (antibodies) is still the same, but the TSI (stimulation) is now LOWER than it was before - simply because these workers are not as effective as they were earlier. (Same situation may have occurred before they went crazy milking, and might have created a hypO situation similar to this, before Graves diagnosis).
As soon as the REGULAR workers (TSH) hear that the TEMP WORKERS aren't performing like they were, they come back from vacation (some are on LONG vacations though) and they try to PUSH these "Blockers" away from the cow, so they can hold the udders. But they can't!!! The Lazy workers (Blocking TRab) hold so tight that the REGULAR (TSH) workers can't get in there and get the milk (hormones) flowing again.
So this cow becomes a non-producer as long as that blocker stays there. (And this is where many endos who are not thyroid specialists confused this situation with HASHI's (Hashimoto's thyroiditis - autoimmune hypOthyroid disease), where they assume the cow has been destroyed. But the cow is NOT dead, it just is being "locked down", or squeezed by the blocking TRab.
This is why we call them "BLOCKING TRab" ---- they don't let anyone on the receptors (cows) and thus prevents stimulation.
If **MOST** of the TEMP workers are "LAZY" types (blocking), then the milk production will come to a HALT! Milk (T4/T3) will fall. This will cause the REGULAR workers to call all their friends (More TSH) to arrive and try to get those Blockers away from the cows!
There may be some fights that occur during all of this --- and a FEW cows might get killed during the battle.... This causes inflammation, cell destruction, and resulting antibodies against those cells themselves in the form of TPOabs, TGabs. But most of the cows will come out just fine unless the TEMP WORKERS bring their home boys (Lymphocytes- white blood cells) to rip the place up! That will down quite a few cows! And milk production will NEVER recover in that case....no matter how many Regular workers are on the job. (ie. Even with very high TSH).
Eventually -- as you get closer to remission - the ATD therapy plucks the TEMP WORKERS (TRab) off the receptors, one by one.....it might take years, but the barn won't be functioning properly UNTIL those TEMP WORKERS are no longer in control of the cows. As the TEMP workers go away, the REGULAR workers come back and take charge again.
Did that help any?
It's really confusing, but once you get the roles that each antibody plays, it makes it all MUCH more simpler to understand....Don't feel bad --- VERY FEW endos know about this unless thyroid is their specialty. That's because this research is all happening in Japan and a few European countries.
The US medical realm in general really don't CARE what these antibodies are doing, so they probably won' t be learning any of this...They feel thyroid ablation (destruction with radiation- the treatment of choice in the US) is all they need to know.... :(
So it will probably be up to those foreign research teams to tell us what these TEMP WORKERS (antibodies) are doing to those "COWS" we have located in our other tissues ---- brain, bones, skin, eyes, etc. That's all still unknown...
Tags: antibodies, autoimmune, graves, t3, t4, tgabs, thyroid, tpoabs, trab, tsh
© 2009 Created by Marie
