Graves’ disease is an autoimmune disorder. It causes your thyroid gland to create too much thyroid hormone in the body. This condition is known as hyperthyroidism. 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 your body. These can include your nervous system function, brain development, body temperature, and other important elements.
If left untreated, hyperthyroidism may cause weight loss, anxiety, jitteriness, irritability, depression, and mental or physical fatigue.
Graves’ disease and hyperthyroidism share many of the same symptoms. These symptoms may include:
- hand tremors
- weight loss
- rapid heart rate (tachycardia)
- intolerance to heat
- muscle weakness
- goiter (swelling in the thyroid gland)
- frequent formed bowel movements
- difficulty sleeping
A small percentage of people with Graves’ disease will experience reddened, thickened skin around the shin area. This is a condition called Graves’ dermopathy.
Another symptom you may experience is known as Graves’ ophthalmopathy. This occurs when your eyes may seem enlarged as a result of your eyelids retracting. When this happens, your eyes may begin to bulge from your eye sockets.
The National Institute of Diabetes and Digestive and Kidney Diseases estimates that 30 percent of people who develop Graves’ disease will get a mild case of Graves’ ophthalmopathy. Up to 5 percent will get severe Graves’ ophthalmopathy.
In autoimmune disorders like Graves’ disease, the immune system begins to fight against healthy tissues and cells in your body. Your immune system usually produces proteins known as antibodies in order to fight against foreign invaders like viruses and bacteria.
These antibodies are produced specially to target the specific invader. In Graves’ disease, your immune system mistakenly produces antibodies called thyroid-stimulating immunoglobulins that target your own healthy thyroid cells.
Although scientists know that people can inherit the ability to make antibodies against their own healthy cells, they have no way to determine what causes Graves’ disease or who will develop it.
Experts believe that these factors may affect your risk of developing Graves’ disease:
The disease is typically found in people younger than 40. Your risk also increases significantly if family members have Graves’ disease. Women develop it seven to eight times more frequently than men.
Having another autoimmune disease also increases your risk of developing Grave’s disease. Rheumatoid arthritis, type 1 diabetes mellitus, and Crohn’s disease are examples of such autoimmune diseases.
Your doctor may request laboratory tests if they suspect you 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 physical examination.
This will still need to be confirmed by 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 tests
- thyroid ultrasound
- radioactive iodine uptake test
- thyroid-stimulating hormone (TSH) test
- thyroid-stimulating immunoglobulin (TSI) 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 (RAI) therapy
- thyroid surgery
Your doctor may suggest you use one or more of these options to treat your disorder.
Antithyroid drugs, such as propylthiouracil or methimazole, may be prescribed. Beta-blockers may also be used to help reduce the effects of your symptoms until other treatments begin to work.
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 talk with you about any precautions you should take with this therapy.
Although thyroid surgery is an option, it’s used less often. Your doctor may recommend surgery if previous treatments haven’t worked correctly or if thyroid cancer is suspected, though thyroid cancer in the setting of Graves’ disease is rare.
Thyroid surgery may also be recommended if you’re pregnant and can’t take antithyroid drugs. In this case, surgery isn’t done until the second trimester because of the risk of miscarriage.
If surgery is necessary, your doctor will remove your entire thyroid gland (total thyroidectomy) to eliminate the risk of hyperthyroidism returning. Total thyroidectomy is the standard of care for people with Graves’ disease.
If you opt for surgery, you will need thyroid hormone replacement therapy on an ongoing basis.
Speak with your doctor to learn more about the benefits and risks of different treatment options.