Graves’ disease is an autoimmune condition that causes the thyroid gland to become overactive (hyperthyroidism). It is the most common cause of hyperthyroidism and is significantly more common in women than men.
What causes Graves’ disease?
In Graves’ disease, the immune system produces antibodies that mistakenly stimulate the thyroid gland. These antibodies cause the thyroid to produce too much thyroid hormone, leading to an overactive thyroid.
Symptoms
Most symptoms are due to excess thyroid hormone and may include:
- Rapid or irregular heartbeat
- Weight loss despite normal appetite
- Tremors and muscle weakness
- Heat intolerance and sweating
- Anxiety, irritability, or sleep problems
Eye involvement (Graves’ eye disease)
Graves’ disease is the only form of hyperthyroidism that can affect the eyes. About one-third of patients develop some eye symptoms, which may include:
- Red or irritated eyes
- Swelling around the eyes
- Bulging of the eyes
- Double vision (less common)
Smoking significantly increases the risk and severity of eye disease. Any eye symptoms should be assessed by both an endocrinologist and an ophthalmologist.
Skin changes
Rarely, Graves’ disease can cause thickened, reddish skin over the shins (pretibial myxedema). This is usually mild.
How is Graves’ disease diagnosed?
Diagnosis is based on:
- Blood tests showing high thyroid hormones (T3, T4) and low TSH
- Thyroid antibody testing (TRAb or TSI), which can confirm Graves’ disease
- In some cases, a radioactive iodine uptake scan or thyroid ultrasound
Treatment options
Graves’ disease is treatable and management is highly effective. Treatment options include:
- Antithyroid medications (Carbimazole or PTU)
- Radioactive iodine therapy
- Surgery (thyroidectomy) in selected cases
Beta-blockers are often used initially to control symptoms. The choice of treatment depends on individual factors and is discussed carefully with your doctor.
Long-term outlook
Some treatments lead to an underactive thyroid (hypothyroidism), which is managed with a simple daily thyroid hormone tablet. With appropriate treatment and monitoring, most people do very well.
Family risk
Graves’ disease has a genetic tendency, however no specific genes have been identified for screening to date.