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About Graves' Disease



Graves’ disease often does not get the attention needed from medical professionals, perhaps because it is rarely fatal. However, Graves' must be treated to avoid complications such as bone/muscle wasting, heart problems, and thyroid storm – a very serious, life-threatening event.  The condition is serious for the millions of individuals who at times, are having problems with their thyroid and experience extreme highs and lows physically and emotionally. The impact on their personalities as they struggle with Graves’ can severely strain their relationship with family and friends.

Graves' disease is an autoimmune disease

Diseases of the immune system have a genetic predisposition. In a normal body, the immune system defends itself against germs and viruses. Other examples of autoimmune disease include Type I diabetes, multiple sclerosis, rheumatoid arthritis, lupus erythematosis, psoriasis, and celiac disease.  Autoimmune diseases can affect different parts of the body. 

Graves' disease and hyperthyroidism

Graves’ disease, also known as toxic diffuse goiter, is the most common cause of hyperthyroidism - a disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs.

The thyroid is a small, butterfly-shaped gland in the front of the neck below the larynx, or voice box. The thyroid gland makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, cholesterol levels, and emotional & cognitive functions.

Thyroid hormone production is regulated by another hormone called thyroid-stimulating hormone (TSH), which is made by the pituitary gland located in the brain.

In Graves’ disease, the immune system makes antibodies called thyroid-stimulating immunoglobulin (TSI) that attach to thyroid cells. TSI mimics the action of TSH and stimulates the thyroid to make too much thyroid hormone. Sometimes the antibodies can instead block thyroid hormone production, leading to a confusing clinical picture.

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.

Graves' disease - Fast Facts

The National Institutes of Health (NIH) provides the following statistics:

  • Graves’ Disease affects approximately 2 to 3% of the population or almost 10 million people. The figure may be higher because some may have eye involvement but not diagnosed with thyroid problems.
  • Graves' is five to 10 times more common in women than men.
  • Graves' usually occurs in middle age, but also occurs in children, adolescents and the elderly.

Recent News

Recent Forum Posts

  • Graves disease and surgery

    Oct. 30, 2014, 8:59 a.m.

    Hello and welcome! Usually, the issue with Graves' and surgery is that the patient is too hypER (i.e. Free T4...

  • Hi - RAI update in UK.

    Oct. 30, 2014, 8:49 a.m.

    Hello - The time frame I usually hear referenced is 6-18 weeks, but that is for patients who have...

  • Ratio between TSH and Free T4 levels?

    Oct. 30, 2014, 8:46 a.m.

    @Sue - The relationship between T4 and TSH is complex and I don't think it's fully understood: (Note on...

  • Hi - RAI update in UK.

    Oct. 30, 2014, 5:21 a.m.

    I had the impression the nurse was meaning they wouldn`t let me become too hyper- but you may be right...

  • Graves disease and surgery

    Oct. 29, 2014, 8:12 a.m.

    My 24 yr old niece is scheduled for surgery to remove the thyroid next week but her tsh levels fluctuate...

  • Ratio between TSH and Free T4 levels?

    Oct. 28, 2014, 9:26 p.m.

    Hey there Ras Lady -nice to “see” you! Cautious hope - I like it, and I think every Gravester...

  • Ratio between TSH and Free T4 levels?

    Oct. 28, 2014, 6:36 p.m.

    Hey Sue! How've ya been? I would be tempted to ask him whether he finds this TSH/FT4 ratio applies in the...

  • Ratio between TSH and Free T4 levels?

    Oct. 28, 2014, 4:07 p.m.

    I had a routine follow up with my endo today. Since my TT July 2013 we have been trying to get my TSH up to...

  • Hypo and Hyper at the same time...sigh

    Oct. 27, 2014, 9:03 p.m.

    Thanks Yes, a second opinion is what I need. My Endo even recommended it. My T3/4 is low based on the lab...

  • Hypo and Hyper at the same time...sigh

    Oct. 27, 2014, 9:03 p.m.

    Thanks Yes, a second opinion is what I need. My Endo even recommended it. My T3/4 is low based on the lab...

  • Hypo and Hyper at the same time...sigh

    Oct. 27, 2014, 11:47 a.m.

    Hello – First, it’s important to know what the reference ranges are for each test, as different labs use...

  • Hi - RAI update in UK.

    Oct. 27, 2014, 11:21 a.m.

    joy123 She said that some people can suffer badly post RAI and they won`t let me, but to give it a week and...

  • Hypo and Hyper at the same time...sigh

    Oct. 27, 2014, 7:21 a.m.

    hi annism,hmmm the pituatary gland?i remember when i had my RAI 20 years ago,my gland was not functioning for...

  • Hypo and Hyper at the same time...sigh

    Oct. 26, 2014, 6:05 p.m.

    I switched to a different endo that my insurance would not cover so it cost me about $250 a visit but it WAS...

  • Hypo and Hyper at the same time...sigh

    Oct. 26, 2014, 5:16 p.m.

    My endo was firm about only using TSH levels but I got my regular Dr to prescribe T3.

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