Published: 18 Jun 2025

ICD9: 242.9      ICD10: E05.90      ICD11: 5A02

Graves' disease is an autoimmune disorder that is the most common cause of hyperthyroidism (overactive thyroid) in the United States.
Here's a breakdown:

Hyperthyroidism:

What it is: A condition where the thyroid gland produces too much thyroid hormone (thyroxine or T4, and triiodothyronine or T3).
Thyroid Hormone Function: Thyroid hormones regulate metabolism, affecting heart rate, body temperature, and energy levels.
Symptoms of Hyperthyroidism:
Nervousness, anxiety, and irritability
Tremor (usually of the hands)
Heat sensitivity
Sweating
Weight loss despite normal or increased appetite
Rapid or irregular heartbeat (palpitations)
Enlarged thyroid gland (goiter)
Changes in menstrual cycles
Frequent bowel movements
Fatigue and muscle weakness
Difficulty sleeping
Thinning skin
Fine, brittle hair

Graves' Disease:

What it is: An autoimmune disorder. The immune system mistakenly attacks the thyroid gland.
How it causes Hyperthyroidism: In Graves' disease, the immune system produces an antibody called thyroid-stimulating immunoglobulin (TSI). TSI mimics thyroid-stimulating hormone (TSH), which is normally produced by the pituitary gland to control thyroid function. TSI binds to TSH receptors on the thyroid gland, causing the thyroid to overproduce thyroid hormones (T4 and T3), leading to hyperthyroidism.
Hallmark Features of Graves' Disease:
Hyperthyroidism: (As described above)
Goiter: Enlargement of the thyroid gland.
Graves' ophthalmopathy: Eye problems, also known as thyroid eye disease (TED). This can include:
Bulging eyes (proptosis)
Gritty sensation in the eyes
Double vision
Eye pain or pressure
Swelling around the eyes
Difficulty closing the eyelids completely
Graves' dermopathy (pretibial myxedema): Rare skin condition where the skin on the shins becomes thick and red.

In simple terms: Graves' disease is an autoimmune disease where the body's immune system stimulates the thyroid gland to overproduce thyroid hormones, causing hyperthyroidism and other specific symptoms like eye problems.

Causes of Graves' Disease:

The exact cause is unknown, but it's believed to involve a combination of genetic and environmental factors.
Risk factors include:
Family history of autoimmune diseases
Gender (more common in women)
Age (most common before age 40)
Stress
Smoking
Pregnancy

Diagnosis:

Physical exam: Doctor will check for goiter, eye signs, and other physical signs of hyperthyroidism.
Blood tests:
Thyroid hormone levels (T4, T3): Elevated levels indicate hyperthyroidism.
TSH (thyroid-stimulating hormone): Low TSH is usually found in hyperthyroidism caused by Graves' disease.
Thyroid-stimulating immunoglobulin (TSI) antibody test: A positive test confirms Graves' disease.
Radioactive iodine uptake scan: This test can help differentiate Graves' disease from other causes of hyperthyroidism. In Graves' disease, the thyroid gland will show increased uptake of radioactive iodine.

Treatment:

The goal of treatment is to reduce the production of thyroid hormones and relieve symptoms. Treatment options include:

Antithyroid medications: These medications (methimazole and propylthiouracil) block the thyroid gland's ability to produce hormones. Methimazole is generally preferred, except during the first trimester of pregnancy when propylthiouracil is often used.
Radioactive iodine therapy: Radioactive iodine is taken orally. It destroys thyroid cells, reducing hormone production. This often leads to hypothyroidism, requiring lifelong thyroid hormone replacement.
Surgery (thyroidectomy): Surgical removal of the thyroid gland. This is usually reserved for cases where other treatments aren't suitable or have failed. After surgery, the patient will need to take thyroid hormone replacement medication for life.
Beta-blockers: These medications (e.g., propranolol, atenolol) don't affect thyroid hormone levels but can help control symptoms like rapid heart rate, tremors, and anxiety.

Management of Graves' Ophthalmopathy (Thyroid Eye Disease):

Mild symptoms: Artificial tears, lubricating gels, sunglasses.
Moderate to severe symptoms:
Corticosteroids: Reduce inflammation.
Teprotumumab: A targeted therapy that can help improve eye bulging and double vision.
Orbital decompression surgery: To create more space for the swollen tissues behind the eye.
Prisms: For double vision.
Eyelid surgery: To improve eyelid closure.
Smoking cessation: Smoking worsens Graves' ophthalmopathy.

Important Considerations:

Graves' disease is a chronic condition, but with appropriate treatment, the symptoms can be managed effectively.
It's crucial to work closely with a doctor (usually an endocrinologist) to develop a personalized treatment plan.
Untreated hyperthyroidism can lead to serious complications, including heart problems, osteoporosis, and thyroid storm (a life-threatening condition).
If you suspect you have Graves' disease or hyperthyroidism, seek medical attention promptly.

This information is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.