Graves disease is an
Diffuse thyrotoxic goiter
The thyroid gland is an important organ of the
Graves disease is the most common cause of hyperthyroidism. It is due to an abnormal immune system response that causes the thyroid gland to produce too much thyroid hormone. Graves disease is most common in women over age 20. But the disorder can occur at any age and can affect men as well.
Younger patients may have these symptoms:
- Breast enlargement in men (possible)
- Difficulty concentrating
- Double vision
- Eyeballs that stick out (
- Eye irritation and tearing
- Frequent bowel movements
Goiter(possible) Heat intolerance Increased appetite
- Increased sweating
- Irregular menstrual periods in women
- Muscle weakness
- Rapid or irregular heartbeat (
palpitationsor arrhythmia) Restlessnessand difficulty sleeping
- Shortness of breath with activity
Weight loss(rarely, weight gain)
Older patients may have these symptoms:
- Rapid or
irregular heartbeat Chest pain
- Memory loss
- Weakness and fatigue
Exams and Tests
The health care provider will do a physical exam and may find that you have an increased heart rate. An exam of your neck may find that your thyroid gland is enlarged (goiter).
Other tests include:
Blood tests to measure levels of TSH, T3, and free T4
Radioactive iodine uptakeand scan
This disease may also affect the following test results:
Orbit CT scanor ultrasound
- Thyroid stimulating immunoglobulin (
- Thyroid peroxidase (TPO) antibody
- Anti-TSH receptor antibody
Treatment is aimed at controlling your overactive thyroid. Medicines called beta-blockers are often used to treat symptoms of rapid heart rate, sweating, and anxiety until the hyperthyroidism is controlled. Hyperthyroidism is treated with one or more of the following:
If you have radiation or surgery, you will need to take replacement thyroid hormones for the rest of your life, because these treatments destroy or remove the gland.
Some of the eye problems related to Graves disease usually improve when hyperthyroidism is treated with medications, radiation, or surgery. Radioactive iodine can sometimes make eye problems worse. Eye problems are worse in people who smoke, even after the hyperthyroidism is cured.
Sometimes prednisone (a steroid medication that suppresses the immune system) is needed to reduce eye irritation and swelling.
You may need to tape your eyes closed at night to prevent drying. Sunglasses and eye drops may reduce eye irritation. In rare cases, surgery or radiation therapy (different from radioactive iodine) may be needed to prevent further damage to the eye and loss of vision.
Graves disease often responds well to treatment. Thyroid surgery or radioactive iodine usually will cause an underactive thyroid (hypothyroidism). Without getting the correct dosage of thyroid hormone replacement, hypothyroidism can lead to:
Mental and physical sluggishness
When to Contact a Medical Professional
Call your health care provider if you have symptoms of Graves disease. Also call if your eye problems or other symptoms get worse or do not improve with treatment.
Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of hyperthyroidism with:
Decrease in consciousness
Rapid, irregular heartbeat