Graves disease: What it is, causes, symptoms & treatment

Overview

Have you ever felt unusually nervous or shaky for no clear reason, noticed a rapid heartbeat, or observed that your eyes seem more prominent than usual? If so, it’s natural to wonder why. One condition that can cause these symptoms is Graves’ disease, an autoimmune disorder that affects the thyroid gland. It is one of the most common causes of an overactive thyroid, but with the right treatment, most people live healthy lives. Let’s explore what Graves’ disease is, why it happens, and how it is treated.

What is Graves’ disease?

Graves’ disease is an autoimmune condition, meaning your body’s immune system mistakenly attacks healthy tissue. It targets the thyroid, a small, butterfly-shaped gland in the neck that controls metabolism, heartbeat, and energy levels. In Graves’ disease, the immune system produces antibodies that make the thyroid gland release an excess of thyroid hormone—a condition known as hyperthyroidism. This hormone overload increases the activity of various body systems, leading to a range of symptoms that may influence your mood, body weight, and even your eyes.

Causes

There’s no single cause, but several factors contribute to the development of Graves’ disease. Risk factors include:

• Autoimmune trigger: The immune system produces thyroid-stimulating immunoglobulins (TSIs) that overstimulate the thyroid.
• Genetic factors: A family history of thyroid or autoimmune diseases.
• Environmental triggers: Stress, smoking, pregnancy, or viral infections may play a role.
• Gender: Women are up to 8 times more likely to develop it than men.

Symptoms

Symptoms differ from person to person, but they usually result from your body functioning faster than normal.

General symptoms:

• Fast or irregular heartbeat (palpitations)
• Fatigue or muscle weakness
• Feeling unusually warm or sweaty
• Shaky hands
• Unexplained weight loss (despite a normal or increased appetite)

Emotional and cognitive symptoms:

• Anxiety, irritability, restlessness
• Difficulty sleeping
• Trouble concentrating
• Feeling more emotional than usual

Eye symptoms (Graves’ Ophthalmopathy)

• Bulging eyes (proptosis)
• Gritty, dry, or watery eyes
• Light sensitivity or double vision

Other physical signs:

• Enlarged thyroid gland (goitre)
• Changes in the menstrual cycle
• Thinning skin or brittle hair
• Swelling in the lower legs (pretibial myxoedema — less common)
• Warm, moist skin

 Diagnoses

Diagnosing Graves’ disease requires a mix of clinical assessment and lab tests to verify thyroid overactivity.

Physical examination

Your primary care GP may observe signs such as a swollen thyroid gland (goitre), tremors, or a rapid pulse.

Blood examinations:

• Increased levels of thyroid hormones (T3 and T4)
• Reduced thyroid-stimulating hormone (TSH)
• The presence of thyroid-stimulating immunoglobulin (TSI) antibodies confirms Graves’ disease.

Note: In complicated situations, your doctor may refer you to an endocrinologist for specialised assessment.

Treatment options

Graves’ disease is very treatable. The best approach depends on factors like age, symptoms, and overall health.

Medications

Antithyroid medications such as carbimazole or propylthiouracil help lower thyroid hormone production. Beta-blockers like propranolol can manage symptoms like rapid heartbeat, tremors, and anxiety. Pros: Non-invasive and effective for many people. Cons: Requires continuous monitoring; relapse may occur after stopping treatment.

Radioactive iodine therapy

This safe and widely used treatment in Australia consists of taking a capsule of radioactive iodine that gradually reduces the size of the thyroid gland. It frequently leads to an underactive thyroid (hypothyroidism), which can be easily managed with daily thyroxine tablets. Pros: Permanent and effective. Cons: May necessitate lifelong hormone replacement.

Surgery (thyroidectomy)

Surgery involves removing part or all of the thyroid gland and is generally suggested when medications or iodine therapy are not suitable. Post-surgery, lifelong thyroid hormone replacement is often required. Pros: Rapid relief from symptoms. Cons: Requires a hospital stay and lifelong medication.

Eye symptom management

Eye issues resulting from Graves’ disease can be alleviated using lubricating eye drops, wearing sunglasses, and administering steroid therapy. Severe instances might require specialised ophthalmological treatment or surgery to relieve pressure and enhance appearance.

Lifestyle and self-care tips

Living with Graves’ disease can be simplified by adopting supportive lifestyle habits that complement medical care.

Diet and nutrition:

• Consume a balanced diet rich in lean proteins, calcium, and fibre.
• Limit excessive iodine consumption (found in seaweed and some supplements).
• Stay hydrated and reduce caffeine intake if it heightens anxiety or palpitations.

Stress management:

Stress can exacerbate autoimmune flare-ups. Mindfulness, yoga, gentle exercises, and relaxation techniques can help keep stress levels under control.

Avoid smoking:

Smoking heightens the likelihood and severity of eye complications associated with Graves’ disease.

Rest and recovery:

Fatigue is common, especially during treatment. Make rest a priority and aim for regular, high-quality sleep.

How Hola Health can help

Hola Health provides:

• Online consultations with GPs for symptom evaluation and thyroid testing.
• Ongoing monitoring of thyroid hormone levels.
• Referrals to endocrinologists or ophthalmologists when necessary.
• Guidance on lifestyle choices for stress reduction, balanced nutrition, and quitting smoking.

Conclusion

Graves’ disease is a manageable condition with prompt diagnosis, appropriate treatment, and healthy lifestyle practices. Regular check-ups with your GP and sticking to your medication regimen can assist in keeping thyroid levels within the normal range and prevent complications.

FAQs

Can Graves’ disease be cured?

Although there is no complete cure, treatments can manage symptoms and often lead to remission.

How is Graves’ disease diagnosed?

Diagnosis is made through blood tests, physical examination, and occasionally thyroid imaging.

What’s the distinction between Graves’ disease and hyperthyroidism?

Graves’ disease is an autoimmune cause of hyperthyroidism, which is a term for any condition characterised by an overactive thyroid.

Is Graves’ disease hereditary?

Yes, it can be passed down in families due to genetic and autoimmune factors.

Can stress activate Graves’ disease?

Chronic stress may influence autoimmune activity and trigger symptoms in those who are predisposed.

How long does treatment take to show effects?

Improvement typically starts within weeks, but achieving complete control may require several months.

Can symptoms related to Graves’ eyes resolve?

Mild eye symptoms often improve with treatment; however, severe cases might need specialised care.