Graves' disease is an autoimmune disorder that causes the thyroid gland to produce too much thyroid hormone, a condition called hyperthyroidism. It occurs when the body’s immune system – which normally fights off infection – mistakenly attacks the thyroid gland, which is located in the neck.
Excess thyroid hormone speeds up the body’s metabolism and affects many different parts of the body. As a result, Graves' disease symptoms can vary widely and may include weight loss, anxiety, heart palpitations, sleep difficulties, and erectile dysfunction or reduced libido.
Some people with Graves’ disease develop a related eye condition called Graves’ ophthalmopathy, which may cause bulging eyes, vision problems, pain, and redness. A rare skin condition called Graves’ dermopathy can also develop, leading to thickened, reddened skin usually on the shins or tops of the feet.
If left untreated, Graves’ disease can lead to serious complications such as pregnancy issues, heart disorders, brittle bones (osteoporosis), and a life-threatening condition called thyroid storm. The sudden increase in thyroid hormones creates a “storm” of effects including severe weakness, fever, seizures, delirium, severe low blood pressure, and even coma.
While Graves’ disease can affect anyone, it is more common in women and people under 40. Newborns may also be affected if their mothers currently have or had Graves’ disease, and the condition may be fatal if not diagnosed promptly.
The treatment for Graves’ disease focuses on reducing thyroid hormone levels and managing symptoms. Options include radioactive iodine therapy (an oral pill with a radioactive substance that targets and destroys overactive thyroid cells), anti-thyroid medications, and surgery to remove part or all of the thyroid gland.
Because the symptoms of Graves’ disease can mimic other conditions, it’s important to see an endocrinology specialist for a timely, accurate diagnosis and appropriate treatment.
Graves’ Disease Causes and Risk Factors
The exact cause of Graves’ disease is unknown. Like other autoimmune disorders, it results from the immune system mistakenly attacks healthy tissue in the body instead of an outside “invader” such as infection. In Graves’ disease, antibodies stimulate the thyroid to produce too much hormone, leading to hyperthyroidism.
The risk factors for Graves’ disease include:
- Family history: You are more likely to develop Graves’ disease if you have a family member with the condition. Researchers are working to identify the specific gene or genes that may cause the disorder.
- Gender: Women are more likely than men to develop the disease
- Age: The disease most often develops before age 40
- Other autoimmune disorders: Immune system diseases such as rheumatoid arthritis or lupus raise the risk of Graves’ disease
- Pregnancy: Increases the risk, especially in women with a family history of the disease
- Stress: Emotional or physical stress may trigger onset in those susceptible to the disease
- Smoking: Increases the risk of Graves’ disease as well as Graves’ ophthalmopathy
Symptoms of Graves’ Disease
The signs and symptoms of Graves’ disease vary and may include:
- Anxiety and irritability
- Bulging eyes (Graves' ophthalmopathy)
- Chest pain
- Difficulty sleeping/insomnia
- Erectile dysfunction or reduced libido
- Eye problems (blurred vision, light sensitivity, grittiness sensation, eye pain)
- Fatigue
- Frequent bowel movements or diarrhea
- Hand tremors
- Heart palpitations (fast or irregular heartbeat)
- Heat sensitivity and increased perspiration
- Increased blood pressure
- Menstrual irregularities
- Muscle weakness
- Restlessness
- Shortness of breath and/or breathing difficulty
- Thick, red skin, usually on the shins or tops of the feet (Graves' dermopathy)
- Thyroid gland enlargement (goiter)
- Weight loss, despite normal or increased appetite
Treating Graves’ Disease
Treating Graves' disease focuses on lowering thyroid hormone levels and reliving symptoms. Treatment options include:
- Radioactive iodine (RAI) therapy: Taken as a pill or liquid, RAI destroys thyroid cells to reduce hormone levels. Most patients only need one dose. Hypothyroidism (too little thyroid hormone) may occur afterward and is managed with synthetic thyroid hormones. RAI cannot be used if you are pregnant or breastfeeding.
- Anti-thyroid medications: These oral medications block the thyroid’s ability to use iodine, helping to reduce hormone production). They may also be used before or after RAI as a supplemental treatment.
- Surgery: Removal of all or part of the thyroid may be recommended. Patients typically take lifelong synthetic thyroid hormone pills afterward.
- Beta blockers: These medications don’t reduce thyroid hormone levels but block their effects on your body, helping to control symptoms like heart palpitations, tremors, anxiety, heat intolerance and sweating, muscle weakness, and diarrhea.
For Graves’ ophthalmopathy, you may be able to manage mild symptoms with over-the-counter lubricating drops and gels. If your symptoms are more severe, your doctor may recommend:
- Corticosteroids to reduce swelling behind the eyeballs
- Prisms in eyeglasses to reduce double vision
- Orbital decompression surgery to relieve eye pressure and reposition bulging eyes, especially in severe cases. This procedure is usually performed for those at risk for vision loss due to pressure on the optic nerve.
Why Choose Cooper to Diagnose and Treat Graves’ Disease
Cooper is home to South Jersey’s largest and most experienced team of Graves’ disease experts. When you choose Coper, you can expect:
- Expert, coordinated care: Our board-certified endocrinologists work with specialists across cardiology, ophthalmology, dermatology, and surgery to address the full spectrum of symptoms and complications related to Graves’ disease
- Advanced treatment options: From anti-thyroid medications and radioactive iodine therapy to surgical treatment when needed, our team uses the latest techniques and approaches to care.
- Comprehensive support: We understand that Graves’ disease can affect multiple body systems – and your quality of life. Cooper has experts in more than 75 specialties, giving you streamlined access to all the expertise you need, all in one place.
- Academic excellence: As faculty at Cooper Medical School of Rowan University, our physicians are leaders in the field, bringing you the latest knowledge and innovation in thyroid care.
Schedule an Appointment
To learn more about the resources available for treating Graves’ disease at Cooper or to request an appointment, please call 800.8.COOPER (800.826.6737).