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Graves Disease


What is Graves disease?

Graves disease is an autoimmune disease that causes your immune system to attack your thyroid gland. This causes your body to make too much thyroid hormone and leads to hyperthyroidism. The thyroid gland is a butterfly-shaped organ that is found in the front part of your neck. Thyroid hormones regulate body temperature, heart rate, and weight.

What increases my risk for Graves disease?

The exact cause of Graves disease is unknown. Certain things may increase your risk of Graves disease. This includes having a family history of Graves disease or being female. Conditions such as type 1 diabetes, rheumatoid arthritis, and vitiligo (a skin disorder) may also increase your risk. Graves disease is more common among females and people younger than 40. Pregnancy affects the thyroid and can trigger Graves disease in some women.

What are the signs and symptoms of Graves disease?

  • Nervousness, irritability, fatigue, or muscle weakness
  • Trouble sleeping or increased sensitivity to heat
  • Hand tremors or increased sweating
  • An irregular or fast heartbeat
  • Diarrhea or more frequent bowel movements than usual
  • Losing weight without trying
  • Children may have a decreased attention span that leads to a drop in school grades
  • Symptoms of Graves ophthalmology (GO) such as protruding eyeballs, puffy eyelids, double vision, light sensitivity, or pain or pressure in your eyes
  • Reddening or thickening of skin on the shins

How is Graves disease diagnosed?

Your healthcare provider will examine you. He may gently feel the area over your thyroid gland for swelling or bumps. He will also ask about your symptoms and any medical conditions you have. You may also need the following tests:

  • Blood tests will be done to measure your thyroid levels. They may also be done to check for antibodies that show you may have Graves disease.
  • Radioactive iodine uptake tests may be done to show how well your thyroid works. It may show that your thyroid gland is producing too much hormone.
  • A thyroid scan may be done to show the size, shape, and position of your thyroid. A small amount of radioactive tracer is given to create pictures of your thyroid.

What is a thyroid storm?

A thyroid storm happens when your thyroid hormone levels get too high. Your body temperature may go very high, your heart may beat very fast, and you may have problems thinking. You may have increased sweating, vomiting, or diarrhea. You may have seizures or go into a coma. Thyroid storm may happen if you have hyperthyroidism and get an infection or stop taking your thyroid medicine. Injuries, burns, and certain medicines can also cause a thyroid storm.

How is Graves disease treated?

  • Antithyroid medicines decrease thyroid hormone levels and your symptoms.
  • Radioactive iodine is given to damage or kill some thyroid gland cells. This may decrease the amount of thyroid hormone produced. Tell your healthcare provider if you are breastfeeding, or you know or think you are pregnant. This medicine can be harmful to your baby.
  • Heart medicine may be given to control and regulate your heart rate.
  • Treatment for eye problems may also be needed. Eye drops can help relieve dry or irritated eyes. Steroids may be given to decrease eye swelling and pain. Special lenses may be needed if you have double vision. Radiation may be applied to your eyes to decrease swelling if you have severe eye problems.
  • Surgery may be done to remove all or part of the thyroid gland.

How can I manage Graves disease?

  • Do not smoke or be around secondhand smoke. Cigarette smoke increases your risk of GO or can make it worse if you already have it. Nicotine and other chemicals in cigarettes and cigars can also cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Sleep with your head elevated if you have eye symptoms. This may help to decrease swelling of your eyelids. Your healthcare provider may recommend that you sleep with your eyes taped shut. This can help to prevent dry eyes.
  • Sunglasses may help to decrease light sensitivity.
  • Take medicine as directed and go to follow-up appointments. Do not stop taking your medicine unless your healthcare provider has asked you to. This could cause your thyroid levels to increase and lead to other health problems. You will need regular follow-up appointments to have your thyroid levels checked.

Call 911 or have someone call 911 for any of the following:

  • You have a seizure.
  • You feel like you are going to faint.
  • You have sudden chest pain or shortness of breath.

When should I seek immediate care?

  • You have a fever.
  • You have trouble thinking clearly.
  • You are shaking or sweating.
  • Your heart is beating faster than usual, or you have an irregular heartbeat.

When should I contact my healthcare provider?

  • You have nausea, vomiting, or diarrhea.
  • You feel nervous, restless, confused or agitated. .
  • You run out of thyroid medicine, or you have stopped taking it.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.