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Lahey Health is now part of Beth Israel Lahey Health

by EBSCO Medical Review Board

Definition

Graves disease is a problem with the immune system that causes the thyroid gland to make too much hormone. The thyroid gland may be large and cause the neck to swell.

Causes

Graves disease is caused by a combination of genetics and environmental factors.

Risk Factors

Graves disease is more common in women. It often is worse between 30 to 60 years of age.

Factors that may raise your risk are:

  • Having a family member with an immune system problem
  • Taking in too much iodine from foods or supplements
  • An overwhelming inflammatory response by the immune system to infection
  • Having certain infections, such as H. pylori infection
  • Stress
  • Smoking
  • Thyroid damage
  • Vitamin D deficiency
  • Selenium deficiency
  • Certain medicines, such as those that affect the immune system

Symptoms

Symptoms may be:

  • A swollen neck
  • Eyes that bulge
  • Weight loss or weight gain
  • Muscle weakness
  • Excess sweating
  • Hair loss
  • Swollen hands and clubbed fingers
  • Eyesight problems
  • Rapid breathing
  • Rapid or uneven heartbeat; chest pain

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. The doctor may suspect a thyroid problem based on symptoms. Blood tests will be done to see how well the thyroid is working.

Images may be taken of your eyes to check for problems. This can be done with orbital imaging methods.

Treatment

Choices for treating Graves disease are:

Medicine

Medicine may be given to treat the thyroid. It may be:

  • Antithyroid medicine to stop the gland from making hormones
  • Radioactive iodine to destroy thyroid tissue cells
  • Beta blockers to ease rapid heartbeat, anxiety, and reactions to heat

Medicine to treat eye problems may be:

  • A selenium supplement to ease swelling
  • Steroids to ease bulging
  • Medicine to suppress the immune system

Surgery

Thyroid removal may be done in people who do not respond to medicine.

Prevention

There are no guidelines to prevent Graves disease.

RESOURCES

Family Doctor—American Academy of Family Physicians  https://www.familydoctor.org 

National Institute of Digestive and Kidney Diseases  https://www.niddk.nih.gov 

CANADIAN RESOURCES

Health Canada  https://www.canada.ca 

Thyroid Foundation of Canada  https://www.thyroid.ca 

References

Graves disease in adults. EBSCO DynaMed website. Available at:  http://www.dynamed.com/topics/dmp~AN~T115280/Graves-Disease-in-Adults  . Accessed August 16, 2020.

Graves’ eye disease (Graves’ ophthalmology). Harvard Health Publishing—Harvard Medical School website. Available at: https://www.health.harvard.edu/a%5Fto%5Fz/graves-eye-disease-graves-ophthalmopathy-a-to-z. Published December 2018. Accessed August 16, 2020.

Hyperthyroidism and Graves’ disease. Michigan Medicine—University of Michigan website. Available at: https://www.uofmhealth.org/conditions-treatments/hyperthyroidism-and-graves-disease. Accessed August 16, 2020.

Ross DS, Burch HB, et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016 Oct;26(10):1343-1421. 

Revision Information

  • Reviewer: EBSCO Medical Review Board James P. Cornell, MD
  • Review Date: 08/2020
  • Update Date: 10/09/2020