Graves' disease is the most common cause of an overactive thyroid gland, or hyperthyroidism. It is an autoimmune condition, where the body’s own immune system produces antibodies which directly stimulate the thyroid gland to produce thyroid hormone. An excess of thyroid hormone leads to a hyper-metabolic state, and causes symptoms such as sweating, palpitations, tremors and weight loss. If Graves’ disease is left untreated, serious complications can result, such as heart failure and rhythm disturbances and eye disease.
What are the symptoms of Graves’ disease?
There is considerable overlap between the symptoms of Graves’ disease and those of other conditions, which can sometimes cause confusion and delay the diagnosis. Below is a list of some of the common symptoms of Graves’ disease:
Unexplained weight loss, even though your appetite may be excessive
Heat intolerance or excessive sweating
Anxiety, Tremors, Restlessness
Difficulty sleeping at night
Rapid or irregular heart rate, palpitations or chest pain
Difficulty breathing or shortness of breath
Goitre (enlarged thyroid gland)
Prominent, bulging eyes
Blurred vision, double vision
Change in menstrual periods
Increased frequency of bowel movements
How is Graves’ disease diagnosed?
A comprehensive assessment involving a detailed history, physical examination and diagnostic tests, including blood tests and imaging, is carried out to make a diagnosis of Graves’ disease. Blood tests include thyroid function tests, to determine if the thyroid gland is overactive, and anti-TSH receptor antibody levels. Imaging tests usually include a thyroid ultrasound, which may detect thyroid nodules or an increased blood flow to the thyroid gland due to its overactivity, as well as a thyroid nuclear scan, which looks at the overall function of the gland. CT and MRI scans may be arranged if there is concern about the size of the thyroid gland and its potential compressive effects on the windpipe, or to assess the orbits (eye sockets) if there is concern regarding thyroid-related eye disease.
What are the treatment options for Graves’ disease?
Graves’ disease is usually treated by an endocrinologist with anti-thyroid medications. This often leads to a remission and medications can be safely ceased. However, Graves' disease is sometimes unable to be controlled with medications, and occasionally patients cannot tolerate medication due to side-effects or contraindications (such as pregnancy). In these situations, surgery in the form of a total thyroidectomy is an excellent treatment option.