Graves’ Disease

Graves’ disease is an autoimmune disorder that affects the thyroid gland. The thyroid is a butterfly-shaped gland located in the front of the neck. It controls your metabolism and body temperature and keeps your organs (like your heart and brain) and muscles working correctly.

With Graves’ disease the immune system attacks the thyroid gland and makes it produce too much thyroid hormone. This can cause hyperthyroidism (overactive thyroid). Early diagnosis and treatment can make a big difference in your overall health.

At Banner Health, we are here to help you understand Graves’ disease and make decisions about your thyroid health. Here’s what you should know about Graves’ disease, including its cause, symptoms and treatment options.

What causes Graves’ disease?

We don’t exactly know what triggers the immune system to attack the thyroid gland. People with a family history of autoimmune disorders (like type 1 diabetes and rheumatoid arthritis) may be at a higher risk. Other risk factors include pregnancy, smoking and possibly stress. 

What are the symptoms of Graves’ disease? 

Signs and symptoms of Graves’ disease are the same as hyperthyroidism and may include: 

• Fast heart rate
• Unintentional weight loss, despite eating normally
• Nervousness
• Shaky or trembling hands
• Excessive sweating
• Eye problems, such as double vision or bulging eyes (known as Graves’ ophthalmopathy)
• Thickening of the skin, especially on the shins (known as pretibial myxedema)
• Irregular menstrual periods
• Erectile dysfunction or loss of sex drive (low libido)
• Swelling in the neck

How is Graves’ disease diagnosed?

Your health care provider will do a physical exam, review your medical history and run some tests. These tests may include:

Blood tests: These tests are used to look at levels of:   

• Hormones called thyroid stimulating hormone (TSH), triiodothyronine (T3) and thyroxine (T4).
• Thyroid antibodies called thyroid stimulating immunoglobulin (TSI) and thyrotropin receptor antibodies (TRAb). 
• A low level of TSH may mean hyperthyroidism. Above normal T3, T4 and antibody levels may mean Graves’ disease.

Radioactive iodine uptake: After swallowing a safe, small amount of radioactive iodine, a special camera will take a picture to measure how much iodine your thyroid absorbs. If it absorbs a lot, your thyroid is making too much T4. 

Imaging tests: Ultrasound may be used to look at your thyroid.

How is Graves’ disease treated?

The goals of treatment are to reduce the amount of thyroid hormone and stop the problems these extra hormones can cause in your body. Treatment options include:

Medications: Anti-thyroid drugs block the ability of your thyroid to make hormones. They are often given before thyroid surgery or radioiodine therapy. 

Beta blockers may also help manage symptoms like rapid heart rate, nervousness and shaky hands, but they don’t treat Graves’ disease.

Radioiodine therapy (RAI): In this treatment, you swallow a radioactive iodine pill, stronger than the one used for diagnosing the disease. It slows your thyroid down to a manageable level.

RAI may temporarily worsen eye problems and lead to low thyroid hormone levels, which can be treated separately. This treatment isn’t recommended for pregnant or breastfeeding people due to radiation. 

Surgery (thyroidectomy): Your provider may recommend removing your thyroid gland. Surgery is a good option for many people, especially those who have an enlarged thyroid due to their Graves’ disease or who are not otherwise good candidates for radioactive iodine. 

After surgery or RAI, you must take daily medication for the rest of your life to maintain normal thyroid hormone levels.

Are there complications of Graves’ disease?

With proper treatment, most people with Graves’ disease can live healthy lives. 

However, if left untreated or poorly managed, Graves’ disease can lead to a serious condition called thyroid storm. Symptoms of thyroid storm include a high fever, sweating, vomiting, diarrhea, delirium, seizures, severe low blood pressure and coma.

Thyroid storm requires immediate emergency care. Call 911 if you or someone else has these symptoms.

What is the outlook for Graves’ disease?

Graves’ disease is a lifelong condition, but it can be managed with treatment and medication. 

Here are some steps you can take:

• Stay healthy: Eat well, exercise regularly, maintain a healthy weight and manage stress. These things are good for your overall health, including your thyroid. Quit smoking and limit alcohol.
• Take medication as prescribed: If your provider gives you medicine for Graves’ disease, it’s important to take it every morning. This keeps your thyroid function regulated and helps you stay healthy.
• Check your thyroid regularly: Work closely with your health care team to ensure your thyroid health remains stable. 
• Be aware of thyroid storm symptoms: Seek immediate emergency care if needed.

Schedule an appointment

Take control of your thyroid health today by scheduling an appointment with one of our endocrinology specialists at Banner Health. Start your journey toward a healthier life.