Graves' Disease

at Concierge Endocrinology of New Jersey

Overview

Graves' disease is an autoimmune condition that affects the function of the thyroid, a butterfly-shaped gland in the lower neck. The thyroid makes hormones that help regulate a wide variety of critical body functions including growth and development, body temperature, heart rate, menstrual cycles, and weight.

In people with Graves' disease, the immune system creates an antibody called thyroid-stimulating immunoglobulin (TSI) that signals the thyroid to increase its production of hormones abnormally. This overactivity of the thyroid (hyperthyroidism) causes many of the signs and symptoms of the disease.

The condition usually appears in mid-adulthood, although it may occur at any age. Between 25 and 50 percent of people with Graves' disease develop eye abnormalities known as Graves' ophthalmopathy. People with Graves' disease also have an increased risk of developing other autoimmune disorders.

Signs & Symptoms

Nervousness or anxiety
Extreme tiredness (fatigue)
Rapid and irregular heartbeat
Hand tremors
Frequent bowel movements or diarrhea
Increased sweating and difficulty tolerating heat
Trouble sleeping
Weight loss despite increased appetite
Menstrual irregularities in women
Enlargement of the thyroid (goiter)
Eye abnormalities — swelling, redness, bulging eyes (Graves' ophthalmopathy)
Skin changes on the lower legs and feet (pretibial myxedema)

Causes & Risk Factors

Autoimmune disorder — the immune system attacks the thyroid gland
Genetic predisposition (variations in HLA complex and other immune-related genes)
Changes in sex hormones, particularly in women
Viral or bacterial infections may trigger the condition
Certain medications
Having too much or too little iodine
Smoking increases the risk of eye problems
Family history of thyroid or autoimmune disease
Increased risk of other autoimmune disorders (rheumatoid arthritis, type 1 diabetes, vitiligo)

Diagnosis

Graves' disease is diagnosed through a combination of physical examination, a review of symptoms and medical history, and laboratory tests.

A key diagnostic tool is autoantibody testing, which checks a blood sample for the presence of thyroid-stimulating immunoglobulin (TSI). Other tests may include a radioactive iodine uptake test to measure how much iodine the thyroid gland is taking up, and thyroid hormone level tests (TSH, T3, and T4).

Treatment Options

Antithyroid medications — drugs that interfere with the thyroid's ability to produce hormones
Radioiodine therapy — selectively destroys overactive thyroid cells (may result in hypothyroidism requiring lifelong replacement)
Surgery (thyroidectomy) — removal of all or part of the thyroid gland in certain cases
Beta-blockers — control symptoms like rapid heart rate, tremors, and anxiety while other treatments take effect
Treatment for Graves' ophthalmopathy when eye symptoms are present
Ongoing monitoring of thyroid hormone levels

Important Facts

Graves' disease is the most common cause of hyperthyroidism.

Between 25 and 50 percent of people with Graves' disease develop eye abnormalities.

Early diagnosis and treatment can help prevent long-term complications including heart problems and bone loss.

People with Graves' disease have an increased risk of developing other autoimmune disorders.

Medical information adapted from MedlinePlus — U.S. National Library of Medicine. Always consult with your physician for personalized medical advice.

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