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Graves’ disease

What is Graves’ disease?

Graves' disease is a condition causing an overactive thyroid gland. It is the most common cause of an overactive thyroid - also called hyperthyroidism.

For a patient with this condition, the thyroid gland in the neck produces too much thyroid hormone.

Graves' disease is named after the doctor who discovered it.

Without treatment, it can be life-threatening causing serious complications.

A person with Graves' disease may find the symptoms go away for periods of time, sometimes months or years.

Thyroid Gland

Symptoms

Symptoms of Graves' disease may include:

 

Causes

Graves' disease is caused by the body's immune system wrongly attacking part of the body - called an autoimmune disease.

The condition may run in families, with some inherited genes playing a role.

Stress is thought to be a trigger for Graves' symptoms.

The condition is also more common among smokers.

Diagnosis

A doctor will make a diagnosis of Graves' disease based on the person's symptoms, their medical history and a physical examination.

Tests will be arranged to confirm the diagnosis of Graves' disease, and to rule out other possible causes or thyroid conditions.

A GP will often make a referral to a thyroid specialist, called an endocrinologist, for further assessment and tests.

Tests to be arranged may include:

  • Thyroid-stimulating hormone (TSH) blood test
  • Thyroxine (FT4) blood test
  • TSH receptor antibody blood test
  • Thyroid scan.

Treatment

The goal of treatment for Graves' disease will be to reduce thyroid hormone levels. In some cases, medication can lead to a complete cure for Graves' disease.

Depending on individual circumstances and how severe the symptoms are, treatments may include:

  • Anti-thyroid drugs that reduce thyroid hormone production. Carbimazole is usually the first drug prescribed, but an alternative called propylthiouracil may be used if there are side effects related to carbimazole, or during pregnancy.
  • Radioactive iodine destroys the thyroid gland meaning that thyroid medication is then needed for life.
  • An operation to remove part of the thyroid may be an option for younger people who develop goitres. Thyroid medication will need to be taken for life after the procedure.

Medical advice should be sought if symptoms worsen or if you have concerns.

Sometimes treatment can make thyroid levels go too low ( hypothyroidism), causing tingling, unplanned weight gain, dry skin, face puffiness and fatigue. Medication doses may need to be adjusted if this happens.

One rare side-effect of anti-thyroid drugs is a lowering of the infection-fighting white blood cells leading to sore throat, mouth ulcers and a fever.

Liver damage is a rare side-effect of propylthiouracil medication causing yellowing of the skin or eyes.

If Graves' disease symptoms mean the eyelids won't close completely over your eyes, eye patches may help at night.

Artificial tears may be recommended to keep the eyes moist.

Regular blood tests will be needed to monitor thyroid levels to check the treatment is working.

Make sure your doctor knows if you are pregnant or planning a pregnancy, as special precautions and treatment changes may be needed.

WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on March 15, 2017

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