8/26/2020 E-Library - Information At Your Fingertips: Printer Friendly citing Racelis v. United Philippine Lines, Inc., 746 Phil. 758, 769 (2014) and David v. OSG Shipmanagement Manila, Inc., 695 Phil. 906, 921 (2012). [84] See Romana, supra note 79, at 168. [85] Id. at 168-170. [86] Douglas S. Ross, et al., 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis, p. 1347 < https://www.liebertpub.com/doi/pdfplus/10.1089/thy.2016.0229 > (visited May 27, 2019); and Rebecca S. Bahn, MD, et al., Hyperthyroidism and Other Causes of Thyrotoxicosis: Management Guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists, p. 459 < https://www.aace.com/files/hyperguidelinesapril2013.pdf > (visited May 27, 2019). See also < https://www.niddk.nih.gov/health-information/endocrine-diseases/gravesdisease > (visited May 27, 2019); < https://www.webmd.com/a-to-zguides/autoimmune-diseases> (visited May 27, 2019); < https://medlineplus.gov/ency/article/000358.htm > (visited May 27, 2019); and < https://www.healthline.com/health/graves-disease > (visited May 27, 2019). Graves' disease is caused by a malfunction in the body's disease-fighting immune system, although the exact reason why this happens is still unknown. One normal immune system response is the production of antibodies designed to target a specific virus, bacterium or other foreign substance. In Graves' disease — for reasons that aren't well understood — the body produces an antibody to one part of the cells in the thyroid gland, a hormone-producing gland in the neck. Normally, thyroid function is regulated by a hormone released by a tiny gland at the base of the brain (pituitary gland). The antibody associated with Graves' disease — thyrotropin receptor antibody (TRAb) — acts like the regulatory pituitary hormone. That means that TRAb overrides the normal regulation of the thyroid, causing an overproduction of thyroid hormones (hyperthyroidism). < https://www.mayoclinic.org/diseases-conditions/graves-disease/symptomscauses/syc-20356240 > (visited May 27, 2019). See further (visited May 27, 2019); and (visited May 27,2019). [87] Normally, "[t]he immune system destroys foreign invaders with substances called antibodies produced by blood cells known as lymphocytes. Sometimes the immune system can be tricked into making antibodies that cross-react with proteins on our own cells. In many cases these antibodies can cause destruction of those cells. In Graves' disease these antibodies (called the thyrotropin receptor antibodies (TRAb) or thyroid stimulating immunoglobulins (TSI) do the opposite – they cause the cells to work overtime. The antibodies in Graves' disease bind to receptors on the surface of thyroid cells and stimulate those cells to overproduce and release thyroid hormones. This results in an overactive thyroid (hyperthyroidism)." < https://www.thyroid.org/gravesdisease/ > (visited May 27, 2019). https://elibrary.judiciary.gov.ph/thebookshelf/showdocsfriendly/1/65357 18/20