Information From Your Health Care Provider

HYPERTHYROIDISM

(Graves' Disease)

Basic information

description

Hyperthyroidism means the thyroid gland is overactive and produces too much thyroid hormone. The most common form of hyperthyroidism is called Graves' disease. The thyroid hormone is used by the body to regulate metabolism (producing energy). Hyperthyroidism often affects adults between ages 20 and 50, mostly women.

FREQUENT SIGNS & SYMPTOMS

Anxiety, nervousness, and restlessness.
Feeling warm or hot all the time; sweating; itchy skin.
Heart palpitations.
Weight loss, even though appetite increases.
Sleeplessness, fatigue, and weakness.
Frequent bowel movements.
Women may have less menstrual flow.
Eyes appear to bulge out, there is swelling around the eyes, and vision changes may occur.
Goiter (visibly enlarged thyroid) may occur.
Hair loss.
Tremor of the hands.
High blood pressure.

causes

Graves' disease is an autoimmune disorder. In these disorders, the immune system by mistake attacks the body itself in different ways. In Graves' disease, abnormal antibodies from the immune system cause the thyroid to produce more hormone. Other causes of hyperthyroidism may be due to disorders of the thyroid.

risk increases with

Thyroid nodules or tumors.
Thyroiditis (inflammation of thyroid gland).
Personal or family history of thyroid or autoimmune diseases.
Radiation treatment.
Females more than males.
Excess iodine intake.
Stress may be a contributing factor.

PREVENTIVE MEASURES

No specific preventive measures.

expected outcomes

Treatment is effective in controlling the disorder. It may take 6 months for the thyroid levels to return to normal.

possible complications

Thyroid eye disease (e.g., visual loss or double vision).
Heart problems.
Bone mineral loss (osteoporosis).
Dermopathy (a skin disorder).
Hypothyroidism (low thyroid hormone levels).
Surgery complications such as infection or bleeding.
Thyroid storm (rare and possibly fatal complication).

diagnosis & treatment

general measures

Your health care provider will do a physical exam. Medical tests include blood studies for thyroid levels. Radioactive iodine studies may be done.
Treatment usually involves drugs to reduce thyroid hormone levels. Permanent treatment involves use of radioactive iodine or surgery. With these two treatments, thyroid hormone production is decreased. Sometimes, hypothyroidism (too little thyroid hormone) occurs, which will need to be treated.
Radioactive iodine treatment is usually done as an outpatient. The iodine (taken by mouth) causes the thyroid gland to shrink over a period of months.
Surgery to remove part of the thyroid (called a thyroidectomy) may be recommended in some cases. This is usually done in a hospital with a general anesthetic.
For eye symptoms, an exam and follow-up care by an eye specialist (ophthalmologist) is often prescribed.

medications

Antithyroid drugs to depress thyroid activity are usually prescribed. Follow-up blood tests are done to adjust the dosage until thyroid hormone levels are normal.
Beta blockers to treat the heart and nervous system symptoms may be prescribed.
Thyroid replacement drugs may be prescribed if the thyroid gland becomes underactive due to treatment.
Avoid any drugs or supplements that contain iodide. Iodide may interfere with drugs used in treatment.

activity

Usually no limits in otherwise healthy persons. In older persons or those with heart problems, decrease activity until thyroid levels are normal.