Graves’ disease is an autoimmune disease that causes a condition called hyperthyroidism. With this condition, your thyroid gland creates too much thyroid hormone in the body. Graves’ disease is one of the most common forms of hyperthyroidism.
In Graves’ disease, your immune system creates antibodies known as thyroid-stimulating immunoglobulins. These antibodies then attach to healthy thyroid cells. They can cause your thyroid to create too much thyroid hormone.
Thyroid hormones affect many aspects of body processes, including nervous system function, brain development, body temperature, and other important things.
Without treatment, hyperthyroidism can eventually lead to:
- weight loss
- mental or physical fatigue
Graves’ disease and hyperthyroidism share many of the same symptoms.
These symptoms can include:
- rapid heart rate (tachycardia)
- hand tremors
- heat sensitivity or intolerance
- weight loss
- sleep problems, including difficulty sleeping and fatigue
- nervousness and irritability
- muscle weakness
- goiter (swelling in your thyroid gland)
- frequent formed bowel movements
- irregular periods
- difficulty becoming pregnant
Some people with Graves’ disease will experience Graves’ dermopathy.
With this condition, you’ll notice reddened, thickened skin around your shins or on the tops of your feet. While Graves’ dermopathy is often mild, it can potentially cause some pain and discomfort.
Graves’ disease can also cause Graves’ ophthalmopathy (GO).
This condition develops when your immune system begins to attack eye tissue and muscle, leaving your eye sockets swollen and inflamed. This inflammation can cause your eyelids to retract, which makes your eyes seem enlarged and bulging.
You might also notice:
- blurred or double vision
- irritated or dry eyes
- sensitivity to light
- pain or a sense of pressure in your eyes
Mild cases of GO might improve on their own. Yet since rare complications can include vision loss, it’s best to mention any eye symptoms you experience to your care team, even mild ones. Be sure to follow any recommended treatment guidelines.
Your immune system usually produces proteins known as antibodies in order to fight against foreign invaders like viruses and bacteria.
If you have an autoimmune disease like Graves’ disease, though, your immune system begins to fight against healthy tissues and cells in your body.
With Graves’ disease, instead of producing antibodies to target a specific invader, your immune system mistakenly produces thyroid-stimulating immunoglobulins. These antibodies then target your own healthy thyroid cells.
Scientists know that people can inherit the ability to make antibodies against their own healthy cells. But they have yet to find a clear cause of Graves’ disease or determine who will develop it.
Experts believe it’s possible that your genes and a virus or other external trigger both play a part in its development.
A few different factors may affect your chance of developing Graves’ disease:
- genetics (family history of the condition)
The disease typically develops in people younger than 40. Your risk also increases significantly if any family members have Graves’ disease. The
Your risk also increases if you have another autoimmune disease. Examples include:
Your doctor may request laboratory tests if they think you might have Graves’ disease. If anyone in your family has had Graves’ disease, your doctor may be able to narrow down the diagnosis based on your medical history and a physical examination.
They’ll still need to confirm the diagnosis through thyroid blood tests. A doctor who specializes in diseases related to hormones, known as an endocrinologist, may handle your tests and diagnosis.
Your doctor may also request some of the following tests:
- blood test
- thyroid ultrasound
- radioactive iodine uptake test
- thyroid-stimulating hormone test
- thyroid-stimulating immunoglobulin test
The combined results of these may help your doctor learn if you have Graves’ disease or another type of thyroid disorder.
Three treatment options are available for people with Graves’ disease:
- antithyroid drugs
- radioactive iodine therapy
- thyroid surgery
Your care team may suggest using one or more of these options to treat the condition.
Your doctor may prescribe antithyroid drugs, including propylthiouracil and methimazole, or beta-blockers.
Beta-blockers don’t treat the condition itself, but they can help lower the effects of your symptoms until other treatments begin to work.
Radioactive iodine therapy
Radioactive iodine therapy is one of the most common treatments for Graves’ disease. This treatment requires you to take doses of radioactive iodine-131.
This usually requires you to swallow small amounts in pill form. Your doctor will explain any important precautions for you to take with this therapy.
Although thyroid surgery is an option, your doctor may not suggest it right away. They may recommend surgery if previous treatments haven’t worked or if they suspect you could have thyroid cancer, though thyroid cancer is rare with Graves’ disease.
They might also recommend thyroid surgery if you’re pregnant and can’t take antithyroid drugs. In this case, they’ll wait to do the surgery until your second trimester because of the risk of miscarriage.
If surgery is necessary, your doctor will remove your entire thyroid gland, a procedure known as a total thyroidectomy. The goal of this surgery is to eliminate the risk of hyperthyroidism returning. Total thyroidectomy is the standard of care for people with Graves’ disease.
After surgery, you’ll need thyroid hormone replacement therapy on an ongoing basis.
Without treatment, Graves’ disease can contribute to heart problems, weak and brittle bones, and pregnancy complications. Prompt treatment, however, can improve your symptoms and help lower your chances of health complications.
Your doctor or healthcare specialist can offer more information about your treatment options, plus their benefits and risks.