Graves' disease is an autoimmune disorder that leads to overactivity of the thyroid gland (hyperthyroidism). It's the most common cause of hyperthyroidism in the United States.

Symptoms

  • Increased Metabolism: Rapid heartbeat, palpitations, increased appetite, unintentional weight loss, nervousness or anxiety, tremors.

  • Heat Sensitivity: Increased sensitivity to heat and excessive sweating.

  • Fatigue and Muscle Weakness: Despite high energy levels.

  • Altered Menstrual Cycles: In women, menstrual cycles may be lighter and less frequent.

  • Erectile Dysfunction and Reduced Libido: In men.

  • Goiter: Enlarged thyroid gland causing swelling at the base of the neck.

  • Graves' Ophthalmopathy: Bulging eyes, red or swollen eyes, sensitivity to light, blurred or double vision, eye pain or discomfort.

  • Graves' Dermopathy: Thick, red skin usually on the shins or tops of the feet.

Causes

Graves' disease is caused by an abnormal immune response that leads to overproduction of thyroid hormones (thyroxine, or T4, and triiodothyronine, or T3). The exact cause of this immune dysfunction is not completely understood but is thought to involve a combination of genetic and environmental factors.

Treatment

Treatment for Graves' disease aims to reduce the production of thyroid hormones and minimize symptoms:

  1. Antithyroid Medications:
    • Methimazole (Tapazole): The most commonly used antithyroid drug in the U.S.

    • Propylthiouracil (PTU): Used in the first trimester of pregnancy or in people intolerant to methimazole.

  2. Radioactive Iodine Therapy: A common and effective treatment that destroys overactive thyroid cells, often leading to hypothyroidism, which is then treated with thyroid hormone replacement.

  3. Surgery (Thyroidectomy): Removal of the thyroid gland, typically followed by lifelong thyroid hormone replacement therapy.

  4. Beta-Blockers: Such as propranolol, are used to relieve symptoms like rapid heart rate, sweating, and anxiety, but do not change thyroid hormone levels.

Medication

  • Methimazole and Propylthiouracil: Reduce thyroid hormone production.

  • Beta-Blockers (e.g., Propranolol): Alleviate symptoms.

Regular monitoring and follow-up care are essential to adjust treatment as needed and to manage any complications. It's important for individuals with Graves' disease to work closely with their healthcare provider to manage the condition effectively.