What is Graves’ Disease?

Graves’ disease is an autoimmune disorder that can cause hyperthyroidism, or overactive thyroid. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats.

With Graves’ disease, your immune system attacks your thyroid gland, causing it to make more thyroid hormones than your body needs. As a result, many of your body’s functions speed up.

Symptoms of Graves’ Disease

Younger people may have these symptoms:

• Anxiety or nervousness, as well as problems sleeping
• Breast enlargement in men (possible)
• Problems concentrating
• Fatigue
• Frequent bowel movements
• Hair loss
• Heat intolerance and increased sweating
• Increased appetite, despite having weight loss
• Irregular menstrual periods in women
• Muscle weakness of the hips and shoulders
• Moodiness, including irritability and anger
• Palpitations (sensation of a strong or unusual heartbeat)
• Rapid or irregular heartbeat
• Shortness of breath with activity
• Tremor (shakiness of the hands)

Many people with Graves disease have problems with their eyes:

• The eyeballs may seem to be bulging out and may be painful.
• Eyes can feel irritated, itchy, or tear more frequently.
• Double vision may be present.
• Decreased vision and damage to the cornea can also occur in severe cases.

Older people may have these symptoms:

• Rapid or irregular heartbeat
• Chest pain
• Memory loss or decreased concentration
• Weakness and fatigue

Causes of Graves’ Disease

Researchers aren’t sure why some people develop autoimmune disorders such as Graves’ disease. These disorders probably develop from a combination of genes and an outside trigger, such as a virus.

With Graves’ disease, your immune system makes an antibody called thyroid-stimulating immunoglobulin (TSI) that attaches to your thyroid cells. TSI acts like thyroid-stimulating hormone (TSH), a hormone made in your pituitary gland that tells your thyroid how much thyroid hormone to make. TSI causes your thyroid to make too much thyroid hormone.

How Common is Graves’ Disease?

Graves’ disease affects nearly 1 in 100 Americans. About 4 out of 5 cases of hyperthyroidism in the United States are caused by Graves’ disease.

Who is more Likely to have Graves’ Disease?

Graves’ disease is more common in women and people older than age 30.2 You are more likely to develop the disease if you

1. Have a family history of Graves’ disease or Hashimoto’s disease
2. Have other autoimmune disorders, such as:

• vitiligo NIH external link, which causes some parts of your skin to lose color
• autoimmune gastritis, which attacks the cells in your stomach lining
• type 1 diabetes, which occurs when your blood glucose, also called blood sugar, is too high
• rheumatoid arthritis NIH external link, which affects your joints and sometimes other parts of your body
• use nicotine products

What are the Complications of Graves’ Disease?

Untreated, Graves’ disease can cause serious health problems, including

• a rapid and irregular heartbeat that can lead to blood clots, stroke, heart failure, and other heart-related problems
• thinning bones, osteoporosis NIH external link, and muscle problems
• problems with the menstrual cycle, fertility, and pregnancy
• eye discomfort and changes in vision

Prognosis of Graves Disease

Graves Disease often responds well to treatment. Thyroid surgery or radioactive iodine often will cause an underactive thyroid (hypothyroidism). Without getting the correct dosage of thyroid hormone replacement, hypothyroidism can lead to:

• Depression
• Mental and physical sluggishness
• Weight gain
• Dry skin
• Constipation
• Cold intolerance
• Abnormal menstrual periods in women

How do Doctors Diagnose Graves’ Disease?

Your doctor will take your medical history and perform a physical exam to look for signs of Graves’ disease. To confirm a diagnosis of Graves’ disease, your doctor may order one or more of these thyroid tests

Blood tests. These tests can measure the levels of your thyroid hormones and also check for TSI.

Radioactive iodine uptake test. This test measures the amount of iodine your thyroid is taking up from your bloodstream to make thyroid hormones. If your thyroid is taking up large amounts of iodine, you may have Graves’ disease.

Thyroid scan. This test, often done together with the radioactive iodine uptake test, shows how and where iodine is distributed in your thyroid. With Graves’ disease, the iodine shows up throughout the gland. With other causes of hyperthyroidism such as nodules—small lumps in the gland—the iodine shows up in a different pattern.

Doppler blood flow measurement NIH external link. This test, also called Doppler ultrasound, uses sound waves to detect increased blood flow in your thyroid due to Graves’ disease. Your doctor may order this test if radioactive iodine uptake is not a good option for you, such as during pregnancy or breastfeeding.

Treatment of Graves’ Disease?

Treatment is aimed at controlling your overactive thyroid. You may receive one or more types of treatment.

Beta-blocker medicines may help treat:

• Rapid heart rate
• Sweating
• Anxiety
• They may be given until the hyperthyroidism is controlled.

Antithyroid medicines:

• Block or change how the thyroid gland uses iodine
• May be used to control the overactive thyroid gland before surgery or radioiodine therapy
• May be used as a long-term treatment

Radioactive iodine is given by mouth. It then concentrates in the overactive thyroid tissue and causes damage.

How Do Eating, Diet, and Nutrition Affect Graves’ Disease?

Your thyroid uses iodine to make thyroid hormones. If you have Graves’ disease or another autoimmune thyroid disorder, you may be sensitive to harmful side effects from too much iodine in your diet. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hyperthyroidism. Taking iodine supplements can have the same effect.

Talk with your health care professional about

• what foods to limit or avoid
• any iodine supplements you take
• any cough syrups or multivitamins you take, because some may contain iodine

Reference:

https://www.niddk.nih.gov/health-information/endocrine-diseases/graves-disease

https://www.mountsinai.org/health-library/diseases-conditions/graves-disease