Graves? disease

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Endocrine glands

Thyroid enlargement - scintiscan

Graves? disease

Alternative Names:

Diffuse thyrotoxic goiter
Treatment:

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 antithyroid medications, radioactive iodine or surgery.

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Both radiation and surgery result in the need for lifelong use of replacement thyroid hormones, because these treatments destroy or remove the gland.

The eye problems related to Graves' disease usually resolve when the hyperthyroidism is effectively treated with medications, radiation or surgery. Sometimes use of prednisone (a steroid medication which suppresses the immune system) is required to reduce eye irritation and swelling.

Taping the eyes closed at night to prevent drying may sometimes be required. Sunglasses and eyedrops may lessen irritation of the eyes. Rarely, surgery may be needed to return the eyes to their normal position.

Expectations (prognosis):

For most people, Graves' disease responds well to treatment. However, thyroid surgery or radioactive iodine will sometimes cause hypothyroidism, which can lead to weight gain, depression and mental and physical sluggishness. Antithyroid medications can also have serious side effects.

Complications:

Eye problems associated with the disease (called Graves' ophthalmopathy or exophthalmos)
Cardiac complications including rapid heart rate, congestive heart failure (especially in the elderly) and atrial fibrillation
Thyroid crisis or storm, a severe worsening of the symptoms of overactivity of the thyroid gland
Increased risk for osteoporosis
Inadequate levels of thyroid hormone medications following surgery or radiation, leading to fatigue, elevated cholesterol levels, mild weight gain, depression and mental and physical sluggishness
Complications related to surgery, including visible scarring of the neck and hoarseness due to damage of the nerve to the voicebox, and low calcium levels due to damage to the parathyroid glands.

Calling your health care provider:

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

Go to the emergency room or call the local emergency number (such as 911) if symptoms of hyperthyroidism are associated with a rapid, irregular heart beat, fever, or a decrease in consciousness.