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Graves disease - MedlinePlus Medical Encyclopedia
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Graves disease

Contents of this page:

Illustrations

Endocrine glands
Endocrine glands
Thyroid enlargement - scintiscan
Thyroid enlargement - scintiscan
Graves' disease
Graves' disease
Thyroid gland
Thyroid gland

Alternative Names    Return to top

Diffuse thyrotoxic goiter

Definition    Return to top

Graves disease is an autoimmune disorder that leads to overactivity of the thyroid gland (hyperthyroidism).

Causes    Return to top

The thyroid gland is an important organ of the endocrine system. It is located in the front of the neck just below the voice box. This gland releases the hormones thyroxine (T4) and triiodothyronine (T3), which control body metabolism. Controlling metabolism is critical for regulating mood, weight, and mental and physical energy levels.

If the body makes too much thyroid hormone, the condition is called hyperthyroidism. (An underactive thyroid leads to hypothyroidism.)

Graves disease is the most common cause of hyperthyroidism. It is caused by an abnormal immune system response that attacks the thyroid gland, and it causes too much production of thyroid hormones. Graves disease is most common in women over age 20. However, the disorder may occur at any age and may affect men as well.

Symptoms    Return to top

Exams and Tests    Return to top

Physical examination shows an increased heart rate. Examination of the neck may show that the thyroid gland is enlarged (goiter).

Other tests include:

This disease may also affect the following test results:

Treatment    Return to top

The purpose of treatment is to control the overactivity of the thyroid gland. Beta-blockers such as propranolol are often used to treat symptoms of rapid heart rate, sweating, and anxiety until the hyperthyroidism is controlled. Hyperthyroidism is treated with:

If you have radiation and surgery, you will need to take replacement thyroid hormones for the rest of your life, because these treatments destroy or remove the gland.

The eye problems related to Graves disease usually improve when hyperthyroidism is treated with medications, radiation, or surgery. Radioactive iodine can sometimes make eye problems worse. Eye problems are worse in people who smoke, even after the hyperthyroidism is cured.

Sometimes prednisone (a steroid medication that suppresses the immune system) is needed to reduce eye irritation and swelling.

You may need to tape your eyes closed at night to prevent drying. Sunglasses and eyedrops may reduce eye irritation. Rarely, surgery may be needed to return the eyes to their normal position.

Outlook (Prognosis)    Return to top

Graves disease often responds well to treatment. However, thyroid surgery or radioactive iodine usually will cause hypothyroidism. Without getting the correct dose of thyroid hormone replacement, hypothyroidism can lead to:

Antithyroid medications can also have serious side effects.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call your health care provider if you have symptoms of Graves disease. Also call if your eye problems or general symptoms get worse (or do not improve) with treatment.

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of hyperthyroidism with:

References    Return to top

AACE Thyroid Task Force. American Association of Clinical Endocrinologists medical guidelines for clinical practice fo rthe evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002;8(6).

Davies TF, Larsen PR. Thyrotoxicosis. In: Kronenberg HM, Shlomo M, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 11.

Update Date: 8/9/2008

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Deborah Wexler, MD, Assistant Professor of Medicine, Harvard Medical School, Endocrinologist, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2009, A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.


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