Graves' disease, an autoimmune disease, is the main cause for a high level of the thyroid hormone. This hormone has several effects on your metabolism and as such, if you have Graves', you may have diarrhea, tremors, a fast heartbeat, weight loss and an intolerance to heat. Your lab report will not show elevated monocytes and liver enzymes, however.
Graves' Disease
Graves' disease is an autoimmune disorder, whereby antibodies attack the thyroid gland instead of only attacking foreign substances. The antibodies do not destroy the gland; instead, they stimulate the gland so that it produces and releases thyroid hormone. This results in hyperthyroidism, or a high amount of the thyroid hormone in the bloodstream. The entire gland becomes large and can grow 2 to 3 times its normal size, according to Douglas Bauer, M.D., Professor of Medicine, Epidemiology and Biostatistics at the University of California in "Pathophysiology of Disease."
Graves' Disease and Thyroid Hormones
A physician will make the diagnosis of Graves' disease based upon your physical exam, medical history and results of lab tests, which will indicate a decrease in thyroid stimulating hormone, or TSH. TSH is released by the anterior pituitary gland of the brain to signal the thyroid to make and release thyroid hormone. Since there is an increased level of thyroid hormone, or triiodothyronine and thyroxine, called T3 and T4 respectively, in Graves', the TSH level is decreased. Graves' does not cause an increase in monocytes or liver enzymes.
Elevated Monocytes
Monocytes are one type of white blood cell; they perform a variety of functions including helping to activate platelets during the formation of clots, fighting bacteria, and killing and devouring foreign substances, all while they migrate in response to various signals. Monocytes do not increase in number as a result of Graves' disease. They will increase as a response to infections and inflammation. There will also be an elevated amount of monocytes in tuberculosis and in a cancer of the white blood cells called chronic myelomonocytic leukemia.
Elevated Liver Enzymes
Alanine aminotransferase and aspartate aminotransferase, usually seen on lab reports as ALT and AST, are the liver enzymes. They are proteins found inside certain cells of the body; both are found inside liver cells. Although there will be a certain amount of these enzymes in the bloodstream, there will be an increased amount if there is any damage to the liver cells that harms the membranes and allows these enzymes to exit. Liver disorders that can cause an increase include cirrhosis, liver cancer and hepatitis. Inflammation in the gallbladder and pancreas can also cause increased levels, as can other diseases, but not Graves'.
References
- "Current Diagnosis & Treatment in Otolaryngology - Head & Neck Surgery"; Anil Lalwani, M.D.; 2008
- MayoClinic.com; Elevated Liver Enzymes; May 2011
- "Pathophysiology of Disease: An Intro to Clinical Medicine"; Stephen McPhee, M.D. et al.; 2010
- The Merck Manual for Healthcare Professionals; Hyperthyroidism; Jerome Hershman, M.D.; June 2008
- "The Washington Manual of Medical Therapeutics"; Gopa Green, M.D., Ian Harris, M.D. et al.; 2004
- "Williams Hematology"; Marshall Lichtman, M.D., Thomas Kipps, M.D. et al.; 2010
