What is Graves" disease?
Graves" disease is an autoimmune disorder that causes hyperthyroidism, or overactive thyroid. With this disease, your immune system attacks the thyroid and causes it khổng lồ make more thyroid hooc môn than your toàn thân needs. The thyroid is a small, butterfly-shaped gl& in the front of your neck. Thyroid hormones control how your body toàn thân uses energy, so they affect nearly every organ in your body—even the way your heart beats.
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If left untreated, hyperthyroidism can cause serious problems with the heart, bones, muscles, menstrual cycle, and fertility. During pregnancy, untreated hyperthyroidism can lead to lớn health problems for the mother & baby. Graves’ disease also can affect your eyes and skin.
How comtháng is Graves" disease?
Graves’ disease is the most comtháng cause of hyperthyroidism in the United States. The disease affects about 1 in 200 people.1
Who is more likely khổng lồ develop Graves" disease?
Graves’ disease usually affects people between ages 30 và 50, but can occur at any age.2 The disease is seven to eight times more comtháng in women than men.3 A person’s chance of developing Graves’ disease increases if other family members have sầu the disease.
People with other autoimmune disorders are more likely lớn develop Graves’ disease than people without these disorders. Conditions linked with Graves’ disease include
What other health problems could I develop because of Graves’ disease?
Without treatment, Graves’ disease can cause some serious health problems, including
Is Graves’ disease during pregnancy a problem?
Thyroid hormone levels that are just a little high are usually not a problem in pregnancy. However, more severe hyperthyroidism that isn’t treated can affect both the mother & the baby. If you have sầu Graves’ disease, be sure your hyperthyroidism is under control before becoming pregnant. Learn more about causes, diagnosis, & treatment of hyperthyroidism during pregnancy.
What are the symptoms of Graves’ disease?
You may have sầu comtháng symptoms of hyperthyroidism such asfast and irregular heartbeat heat intolerance nervousness or irritability tiredness or muscle weakness trembling hands trouble sleeping weight loss
Rarely, people with Graves’ disease develop a reddish thickening of the skin on the shins, a condition called pretibial myxedema or Graves’ dermopathy. This skin problem is usually painless & mild, but it can be painful for some.
GO can cause retracted eyelids, meaning the eyelids are pulled bachồng from the eye. GO can also cause bulging eyes, double vision, and swelling around the eyes.
What causes Graves’ disease?
Researchers aren’t sure why some people develop autoimmune disorders such as Graves’ disease. These disorders probably develop from a combination of genes & an outside trigger, such as a virut.
With Graves’ disease, the immune system makes an antitoàn thân called thyroid-stimulating immunoglobulin (TSI) that attaches khổng lồ thyroid cells. TSI acts like thyroid-stimulating hooc môn (TSH), a hormone made in the pituitary glvà that tells the thyroid how much thyroid hormone khổng lồ make. TSI causes the thyroid khổng lồ make too much thyroid hormone.
How vày health care professionals diagnose Graves’ disease?
Your health care provider may suspect Graves’ disease based on your symptoms & findings during a physical exam. One or more blood tests can confirm that you have hyperthyroidism and may point khổng lồ Graves’ disease as the cause.
Other clues that hyperthyroidism is caused by Graves’ disease arean enlarged thyroid signs of Graves’ eye disease, present in about one out of three people with Graves’ disease4 a history of other family members with thyroid or autoimmune problems
If the diagnosis is uncertain, your doctor may order further blood or imaging tests to lớn confirm Graves’ disease as the cause.
A blood demo can detect TSI. However, in mild cases of Graves’ disease, TSI may not show up in your blood. The next step may be one of two imaging tests that use small, safe doses of radioactive iodine. Your thyroid collects iodine from your bloodstream and uses it to make thyroid hormones; it will collect radioactive sầu iodine in the same way.Radioactive sầu iodine uptake thử nghiệm. This chạy thử measures the amount of iodine the thyroid collects from the bloodstream. If your thyroid collects large amounts of iodine, you may have sầu Graves’ disease. Thyroid scan. This scan shows how and where iodine is distributed in the thyroid. With Graves’ disease, the entire thyroid is involved, so the iodine shows up throughout the gl&. With other causes of hyperthyroidism such as nodules—small lumps in the gland—the iodine shows up in a different pattern.
Learn more about thyroid tests.
What are my treatment options for Graves’ disease?
You have three treatment options: medicine, radioiodine therapy, and thyroid surgery. Radioiodine therapy is the most common treatment for Graves’ disease in the United States,4 but doctors are beginning to lớn use medicine more often than in the past.5,6 Based on factors such as your age, whether you are pregnant, or whether you have other medical conditions, your doctor may recommover a specific treatment và can help you decide which one is right for you.
For radioiodine therapy, you take radioactive iodine-131 (I-131) by mouth as a capsule or liquid. I-131, at a higher dose than the dose used for imaging tests, slowly destroys the cells of the thyroid gl& that produce thyroid hormone. The dose of I-131 usually used for radioiodine therapy does not affect other body toàn thân tissues.
Although it’s unlikely, you may need more than one radioiodine treatment khổng lồ bring your thyroid hormone levels inkhổng lồ the normal range. In the meantime, treatment with medicines called beta blockers can control your symptoms.
Almost everyone who has radioactive sầu iodine treatment later develops hypothyroidism, or underactive thyroid, because the thyroid hormone-producing cells have sầu been destroyed. However, hypothyroidism is easier to treat and causes fewer long-term health problems than hyperthyroidism. People with hypothyroidism can completely control the condition with daily thyroid hooc môn medicine.
Doctors don’t use radioiodine therapy to treat pregnant women or women who are breastfeeding. Radioactive sầu iodine can harm the fetus’ thyroid và can be passed from mother khổng lồ child in breast milk.
Beta blockers. Beta blockers don’t stop your thyroid from producing thyroid hooc môn but can reduce symptoms until other treatments take effect. These medicines act quickly lớn relieve sầu many of the symptoms of hyperthyroidism, such as trembling, rapid heartbeat, and nervousness. Most people feel better within hours of taking beta blockers.
Antithyroid medicines. Antithyroid therapy is the simplest way to treat hyperthyroidism. Antithyroid medicines cause your thyroid khổng lồ make less thyroid hormone. These medicines usually don’t provide a permanent cure, but in some people, the effects last a long time after they stop taking the medicine. Doctors most often use the antithyroid medicine methimazole.
Doctors usually treat pregnant và breastfeeding women with antithyroid medicine, since this treatment may be safer for the baby than other treatments. Doctors use propylthiouracil more often than methimazole during the first 3 months of pregnancy because methimazole may harm the fetus, although this happens rarely. Also rarely, propylthiouracil may affect the fetus, but any effects are less harmful than having uncontrolled hyperthyroidism during pregnancy.
Once treatment with antithyroid medicine begins, your thyroid hooc môn levels may not move into lớn the normal range for several weeks or months. The total average treatment time is about 12 khổng lồ 18 months,7 but treatment can continue for many years in people who don’t want radioiodine or surgery to treat their Graves’ disease.
Antithyroid medicines can cause side effects in some people, includingallergic reactions such as rashes and itching a decrease in the number of trắng blood cells in your toàn thân, which can lower resistance to lớn infection
gọi your doctor right away if you have any of the following symptoms:fever sore throat tiredness weakness loss of appetite skin rash or itching easy bruising yellowing of your skin or whites of your eyes, called jaundice constant sore throat fever
The least-used treatment for Graves’ disease is surgery khổng lồ remove sầu the thyroid glvà. Sometimes doctors use surgery khổng lồ treat people with large goiters, or pregnant women who are allergic to or have side effects from antithyroid medicines.
Before surgery, your doctor will prescribe antithyroid medicines khổng lồ bring your thyroid hooc môn levels inkhổng lồ the normal range. This treatment prevents a condition called thyroid storm—a sudden, severe worsening of symptoms—that can occur when people with hyperthyroidism have sầu general anesthesia.
After surgery lớn remove sầu your thyroid, you will develop hypothyroidism và need khổng lồ take thyroid hormone medicine every day for life. After surgery, your doctor will continue to lớn kiểm tra your thyroid hormone levels và adjust your dose as needed.
What is Graves’ ophthalmopathy (GO)?
GO is a condition that occurs when the immune system attacks the muscles và other tissues around the eyes.
The result is inflammation and a buildup of tissue & fat behind the eye socket, causing the eyeballs khổng lồ bulge out. Rarely, inflammation is severe enough to compress, or push on, the optic nerve that leads from the eye to lớn the brain, causing vision loss.
Besides bulging eyes, other GO symptoms aredry, gritty, & irritated eyes puffy or retracted eyelids double vision light sensitivity pressure or pain in the eyes trouble moving the eyes
About one in three people with Graves’ disease develop mild GO, và about 5 percent develop severe GO.7 This eye condition usually lasts 1 lớn 2 years & often improves on its own.
GO can occur before, at the same time as, or after other symptoms of hyperthyroidism develop. Eye problems sometimes develop long after Graves’ disease has been treated, but this happens rarely. GO may even occur in people whose thyroid function is normal. Smoking makes GO worse. If you smoke và need help quitting, go lớn SmokeFree.gov.
The eye problems of Graves’ disease may not improve sầu after thyroid treatment, so doctors often treat the two problems separately.
Eye drops can relieve dry, gritty, irritated eyes—the most comtháng of the milder symptoms. If pain và swelling occur, your doctor may prescribe a steroid such as prednisone. Other medicines that reduce your body’s immune response, such as rituximab, may also provide relief.
Sunglasses can help with light sensitivity. Special eyeglass lenses may help reduce double vision. If you have sầu puffy eyelids, your doctor may advise you to lớn sleep with your head raised to lớn reduce swelling. If your eyelids vì not fully cthất bại, taping them shut at night can help prsự kiện dry eyes.
Your doctor may recommkết thúc surgery khổng lồ improve sầu bulging of your eyes and correct the vision changes caused by pressure on the optic nerve. A procedure called orbital decompression makes the eye socket bigger & gives the eye room to lớn sink baông chồng khổng lồ a more normal position. Eyelid surgery can return retracted eyelids to lớn their normal position.
Rarely, doctors treat Graves’ eye disease with radiation therapy to lớn the muscles and tissues around the eyes.
What should I avoid eating if I have sầu Graves’ disease?
People with Graves’ disease may be sensitive to harmful side effects from iodine. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hyperthyroidism. Taking iodine supplements can have sầu the same effect.
Talk with your health care professional about what foods you should limit or avoid, & let hyên or her know if you take iodine supplements. Also, nội dung information about any cough syrups or multivitamins that you take because they may contain iodine.
<1> Genetics Home Reference. National Library of Medicine. National Institutes of Health. Published August 2017; last reviewed July 2013. https://ghr.nlm.onfire-bg.com.gov/condition/graves-disease#statistics. Accessed August 17, 2017.
<2> Smith TJ, Hededüs L. Graves’ disease. The New Engl& Journal of Medicine. 2016;375(16):1552-1565.
<3> Yeung SJ, Habra MA, Chiu AC. Graves’ disease. Medscape emedicine trang web. http://emedicine.medscape.com/article/120619-overview#a6. Updated March 2017. Accessed August 17, 2017.
<4> Ross DS, Burch HB, Cooper DS, et al. năm 2016 American Thyroid Association guidelines for diagnosis & management of hyperthyroidism & other causes of thyrotoxicosis. Thyroid. 2016;26(10):1343–1421.
<5> Burch HB, Burman KD, Cooper DS. A 2011 survey of clinical practice patterns in the management of Graves" disease. Journal of Clinical Endocrinology & Metabolism. 2012 Dec;97(12):4549-4558.
<6> Brito lớn JPhường, Schilz S, Singh Ospina N, Rodriguez-Gutierrez R, Maraka S, Sangaralingyêu thích LR, Montori VM. Antithyroid drugs—the most common treatment for Graves" Disease in the United States: a nationwide population-based study. Thyroid. 2016 Aug;26(8):1144-1145.
<7> Burch HB, Cooper DS. Management of Graves disease: a Đánh Giá. JAMA. 2015;314(243):2544-2554.