Graves’ Disease

Fast Facts: Graves' Disease

  • Graves' disease is named for Sir Robert Graves, an Irish physician who lived in the early 19th century.
  • The preferred usage is Graves' with an apostrophe - although medical geneticists refer to the condition as Graves disease without the apostrophe.
  • In Graves’ disease, antibodies are produced against certain proteins on the surface of cells. These targets may include the TSH receptors on the thyroid gland, the connective tissue cells surrounding the eyes, and the pretibial skin located on the front of the shin.
  • When the thyroid gland is stimulated to overproduce thyroid hormones, this results in hyperthyroidism.
  • Symptoms can develop gradually and may initially be mistaken for anxiety or stress. However, hyperthyroidism can become serious and must be treated to avoid complications such as bone/muscle wasting, heart problems, and thyroid storm – a very serious, life-threatening event.
  • Graves' disease is typically diagnosed via blood tests including thyroid function tests (TSH, Free T4, and T3) and antibody tests (TRAb or TSI). Your doctor might also order an ultrasound or a radioactive iodine uptake test (RAIU) and thyroid scan.
  • See below for more detailed information, including signs and symptoms, treatment options, eye involvement, and skin involvement. 

Signs and Symptoms (every patient is unique, so you might not experience all of these):

  • Rapid heartbeat
  • Heart palpitations
  • Unexplained weight loss
  • Increased appetite
  • Restlessness
  • Decreased attention span
  • Shortness of breath
  • Muscle weakness

  • Insomnia
  • Heat intolerance
  • Increased perspiration
  • Frequent bowel movements
  • Lighter menstrual periods
  • Unexplained Fatigue
  • Unexplained anxiety
  • Unexplained mood changes

Treatment Options

While there are currently no cures for the autoimmune component of Graves’ disease, treatment focuses on correcting the hyperthyroid state and restoring thyroid levels to normal. Three different approaches are available. They include Anti-Thyroid Drugs (ATDs), Radioactive Iodine (RAI), and Surgery to remove the thyroid gland. A final decision should be made in conjunction with an endocrinologist or other qualified medical professionals. Although practices like good nutrition, stress reduction, adequate sleep, and exercise* are good for overall health, there are currently no "alternative" treatment options that have been proven to be effective in Graves' disease. 

*Check with your doctor before starting a new exercise routine, particularly if you have uncontrolled hyperthyroidism.

Eye and Skin Involvement

Patients with Graves’ disease may experience some level of eye involvement, requiring consultation with an experienced ophthalmologist. Symptoms can include dry eyes, swelling, redness, eyelid retraction, and a “gritty” sensation. Less common complications include bulging (proptosis), double vision, and compression of the optic nerve. Symptoms typically progress and then stabilize over a period of 2-3 years. For more serious complications, surgical options are available to restore eye function and appearance.

Very occasionally, Graves’ patients develop a lumpy reddish thickening of the skin in front of the shins known as pretibial myxedema. This condition is usually diagnosed and treated by a dermatologist. Even rarer is a condition called acropachy, a clubbing and swelling of the fingers or toes.