Graves' Disease

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thyroid gland in the neck

Graves’ disease is the most common kind of hyperthyroidism (HI per thy ROID ism). It happens when a person’s immune system acts against his or her thyroid gland by mistake. It makes too much of the hormone thyroxine (thy ROX in). The thyroid gland is in the neck.

Graves’ disease can happen at any age in both males and females. It is more common in women and usually begins after age 20. It is easily treated.

Symptoms

Signs and symptoms of Graves’ disease include:

  • Fast or irregular heart beat
  • Sensitivity to heat/cold
  • High blood pressure
  • Hair that breaks easily
  • Shakiness in the hands
  • Change in periods
  • Increased energy
  • Bulging eyes
  • Irritability
  • Difficulty swallowing or feeling like neck is swollen
  • Difficulty sleeping
  • Weight loss even when eating normal amounts
  • Tiredness

Causes

Doctors are not sure what causes Graves’ disease.

There are certain risk factors that may increase the chance that you will have it, such as:

  • Family history of the disease
  • Age − usually happens after age 20
  • Sex − women are more likely to have it
  • Smoking

Complications

When the body makes too much thyroid hormone, other problems can happen, such as:

  • Heart problems: fast heart rate, irregular heart rate, and congestive heart failure. Your doctor can treat these problems.

  • Brittle bones: too much thyroid hormone affects your body’s ability to get calcium into your bones.

  • Thyrotoxic crisis: a sudden increase in the symptoms of hyperthyroidism, like fast heart rate and confusion. This rarely happens. Get medical care right away if it does.

Tests and Diagnosis

  • Blood tests: to measure thyroid-stimulating hormone (TSH) and thyroxine (T4) levels

  • Physical exam: to find out about your symptoms

  • Scan: thyroid uptake scan to measure the level of radioactive iodine found in the thyroid gland. A high uptake means your thyroid gland is making too much thyroxine.

These tests help your doctor plan the best medical treatment.

Treatment

Treatment helps manage the symptoms of Graves’ disease. It reduces the level of thyroxine hormone or blocks its action. Options are:

  • Beta blockers: medicine to treat symptoms like fast heart rate, sweating, anxiety .

  • Anti-thyroid medicines: drugs like methimazole to stop the thyroid from making too much thyroxine. Usually you will take this medicine for at least 2 years. This treatment can lead to remission, but hyperthyroidism can come back again.

  • Radioactive iodine: when your take this, the iodine collects in the thyroid gland.    The radioactivity destroys the overactive thyroid cells and eventually the thyroid gland. Your child will have to take thyroid medicine to replace the thyroid hormone.

  • Surgery: to take out the thyroid gland. Your child will have to take thyroid medicine to replace the thyroid hormone.

Follow-up Care

Your child will need ongoing care to make sure hormone levels stay in the normal range. He will need regular physical exams and blood work.

Graves’ Disease (PDF)

HH-I-347 9/12 Revised 3/15 Copyright 2012, Nationwide Children's Hospital