Graves disease life expectancy

Graves’ Disease

On this page:

  • What is Graves’ disease?
  • How common is Graves’ disease?
  • Who is more likely to develop Graves’ disease?
  • What other health problems could I develop because of Graves’ disease?
  • Is Graves’ disease during pregnancy a problem?
  • What are the symptoms of Graves’ disease?
  • What causes Graves’ disease?
  • How do health care professionals diagnose Graves’ disease?
  • What are my treatment options for Graves’ disease?
  • What is Graves’ ophthalmopathy (GO)?
  • What should I avoid eating if I have Graves’ disease?

What is Graves’ disease?

Graves’ disease is an autoimmune disorder that causes hyperthyroidism, or overactive thyroid. With this disease, your immune system attacks the thyroid and causes it to make more thyroid hormone than your body needs. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control how your body uses energy, so they affect nearly every organ in your body—even the way your heart beats.

The thyroid is a small gland in your neck that makes thyroid hormones.

If left untreated, hyperthyroidism can cause serious problems with the heart, bones, muscles, menstrual cycle, and fertility. During pregnancy, untreated hyperthyroidism can lead to health problems for the mother and baby. Graves’ disease also can affect your eyes and skin.

How common is Graves’ disease?

Graves’ disease is the most common cause of hyperthyroidism in the United States. The disease affects about 1 in 200 people.1

Who is more likely to develop Graves’ disease?

Graves’ disease usually affects people between ages 30 and 50, but can occur at any age.2 The disease is seven to eight times more common in women than men.3 A person’s chance of developing Graves’ disease increases if other family members have the disease.

People with other autoimmune disorders are more likely to develop Graves’ disease than people without these disorders. Conditions linked with Graves’ disease include

  • rheumatoid arthritis, a disorder that affects the joints and sometimes other body systems
  • pernicious anemia, a condition caused by a vitamin B12 deficiency
  • lupus, a chronic, or long-term, disorder that can affect many parts of your body
  • Addison’s disease, a hormonal disorder
  • celiac disease, a digestive disorder
  • vitiligo, a disorder in which some parts of the skin are not pigmented
  • type 1 diabetes

What other health problems could I develop because of Graves’ disease?

Without treatment, Graves’ disease can cause some serious health problems, including

  • an irregular heartbeat that can lead to blood clots, stroke, heart failure, and other heart-related problems
  • an eye disease called Graves’ ophthalmopathy or Graves’ orbitopathy (GO), which can cause double vision, light sensitivity, and eye pain—and, rarely, can lead to vision loss
  • thinning bones and osteoporosis

Is Graves’ disease during pregnancy a problem?

Thyroid hormone levels that are just a little high are usually not a problem in pregnancy. However, more severe hyperthyroidism that isn’t treated can affect both the mother and the baby. If you have Graves’ disease, be sure your hyperthyroidism is under control before becoming pregnant. Learn more about causes, diagnosis, and treatment of hyperthyroidism during pregnancy.

What are the symptoms of Graves’ disease?

You may have common symptoms of hyperthyroidism such as

  • fast and irregular heartbeat
  • frequent bowel movements or diarrhea
  • goiter
  • heat intolerance
  • nervousness or irritability
  • tiredness or muscle weakness
  • trembling hands
  • trouble sleeping
  • weight loss

Rarely, people with Graves’ disease develop a reddish thickening of the skin on the shins, a condition called pretibial myxedema or Graves’ dermopathy. This skin problem is usually painless and mild, but it can be painful for some.

GO can cause retracted eyelids, meaning the eyelids are pulled back from the eye. GO can also cause bulging eyes, double vision, and swelling around the eyes.

What causes Graves’ disease?

Researchers aren’t sure why some people develop autoimmune disorders such as Graves’ disease. These disorders probably develop from a combination of genes and an outside trigger, such as a virus.

With Graves’ disease, the immune system makes an antibody called thyroid-stimulating immunoglobulin (TSI) that attaches to thyroid cells. TSI acts like thyroid-stimulating hormone (TSH), a hormone made in the pituitary gland that tells the thyroid how much thyroid hormone to make. TSI causes the thyroid to make too much thyroid hormone.

How do health care professionals diagnose Graves’ disease?

Your health care provider may suspect Graves’ disease based on your symptoms and findings during a physical exam. One or more blood tests can confirm that you have hyperthyroidism and may point to Graves’ disease as the cause.

Other clues that hyperthyroidism is caused by Graves’ disease are

  • an enlarged thyroid
  • signs of Graves’ eye disease, present in about one out of three people with Graves’ disease4
  • a history of other family members with thyroid or autoimmune problems

If the diagnosis is uncertain, your doctor may order further blood or imaging tests to confirm Graves’ disease as the cause.

A blood test can detect TSI. However, in mild cases of Graves’ disease, TSI may not show up in your blood. The next step may be one of two imaging tests that use small, safe doses of radioactive iodine. Your thyroid collects iodine from your bloodstream and uses it to make thyroid hormones; it will collect radioactive iodine in the same way.

  • Radioactive iodine uptake test. This test measures the amount of iodine the thyroid collects from the bloodstream. If your thyroid collects large amounts of iodine, you may have Graves’ disease.
  • Thyroid scan. This scan shows how and where iodine is distributed in the thyroid. With Graves’ disease, the entire thyroid is involved, so the iodine shows up throughout the gland. With other causes of hyperthyroidism such as nodules—small lumps in the gland—the iodine shows up in a different pattern.

Learn more about thyroid tests.

What are my treatment options for Graves’ disease?

You have three treatment options: medicine, radioiodine therapy, and thyroid surgery. Radioiodine therapy is the most common treatment for Graves’ disease in the United States,4 but doctors are beginning to use medicine more often than in the past.5,6 Based on factors such as your age, whether you are pregnant, or whether you have other medical conditions, your doctor may recommend a specific treatment and can help you decide which one is right for you.

Radioiodine therapy

For radioiodine therapy, you take radioactive iodine-131 (I-131) by mouth as a capsule or liquid. I-131, at a higher dose than the dose used for imaging tests, slowly destroys the cells of the thyroid gland that produce thyroid hormone. The dose of I-131 usually used for radioiodine therapy does not affect other body tissues.

You take radioactive iodine-131 as a capsule or liquid.

Although it’s unlikely, you may need more than one radioiodine treatment to bring your thyroid hormone levels into the normal range. In the meantime, treatment with medicines called beta blockers can control your symptoms.

Almost everyone who has radioactive iodine treatment later develops hypothyroidism, or underactive thyroid, because the thyroid hormone-producing cells have been destroyed. However, hypothyroidism is easier to treat and causes fewer long-term health problems than hyperthyroidism. People with hypothyroidism can completely control the condition with daily thyroid hormone medicine.

Doctors don’t use radioiodine therapy to treat pregnant women or women who are breastfeeding. Radioactive iodine can harm the fetus’ thyroid and can be passed from mother to child in breast milk.

Medicines

Beta blockers. Beta blockers don’t stop your thyroid from producing thyroid hormone but can reduce symptoms until other treatments take effect. These medicines act quickly to relieve many of the symptoms of hyperthyroidism, such as trembling, rapid heartbeat, and nervousness. Most people feel better within hours of taking beta blockers.

Antithyroid medicines. Antithyroid therapy is the simplest way to treat hyperthyroidism. Antithyroid medicines cause your thyroid to make less thyroid hormone. These medicines usually don’t provide a permanent cure, but in some people, the effects last a long time after they stop taking the medicine. Doctors most often use the antithyroid medicine methimazole.

Doctors usually treat pregnant and breastfeeding women with antithyroid medicine, since this treatment may be safer for the baby than other treatments. Doctors use propylthiouracil more often than methimazole during the first 3 months of pregnancy because methimazole may harm the fetus, although this happens rarely. Also rarely, propylthiouracil may affect the fetus, but any effects are less harmful than having uncontrolled hyperthyroidism during pregnancy.

Once treatment with antithyroid medicine begins, your thyroid hormone levels may not move into the normal range for several weeks or months. The total average treatment time is about 12 to 18 months,7 but treatment can continue for many years in people who don’t want radioiodine or surgery to treat their Graves’ disease.

Antithyroid medicines can cause side effects in some people, including

  • allergic reactions such as rashes and itching
  • a decrease in the number of white blood cells in your body, which can lower resistance to infection
  • liver failure, in rare cases

Call your doctor right away if you have any of the following symptoms:

  • fever
  • sore throat
  • tiredness
  • weakness
  • dull pain in your abdomen
  • loss of appetite
  • skin rash or itching
  • easy bruising
  • yellowing of your skin or whites of your eyes, called jaundice
  • constant sore throat
  • fever

Thyroid surgery

The least-used treatment for Graves’ disease is surgery to remove the thyroid gland. Sometimes doctors use surgery to treat people with large goiters, or pregnant women who are allergic to or have side effects from antithyroid medicines.

Before surgery, your doctor will prescribe antithyroid medicines to bring your thyroid hormone levels into the normal range. This treatment prevents a condition called thyroid storm—a sudden, severe worsening of symptoms—that can occur when people with hyperthyroidism have general anesthesia.

After surgery to remove your thyroid, you will develop hypothyroidism and need to take thyroid hormone medicine every day for life. After surgery, your doctor will continue to check your thyroid hormone levels and adjust your dose as needed.

What is Graves’ ophthalmopathy (GO)?

GO is a condition that occurs when the immune system attacks the muscles and other tissues around the eyes.

The result is inflammation and a buildup of tissue and fat behind the eye socket, causing the eyeballs to bulge out. Rarely, inflammation is severe enough to compress, or push on, the optic nerve that leads from the eye to the brain, causing vision loss.

Symptoms

Besides bulging eyes, other GO symptoms are

  • dry, gritty, and irritated eyes
  • puffy or retracted eyelids
  • double vision
  • light sensitivity
  • pressure or pain in the eyes
  • trouble moving the eyes

About one in three people with Graves’ disease develop mild GO, and about 5 percent develop severe GO.7 This eye condition usually lasts 1 to 2 years and often improves on its own.

GO can occur before, at the same time as, or after other symptoms of hyperthyroidism develop. Eye problems sometimes develop long after Graves’ disease has been treated, but this happens rarely. GO may even occur in people whose thyroid function is normal. Smoking makes GO worse. If you smoke and need help quitting, go to SmokeFree.gov.

Treatment

The eye problems of Graves’ disease may not improve after thyroid treatment, so doctors often treat the two problems separately.

Eye drops can relieve dry, gritty, irritated eyes—the most common of the milder symptoms. If pain and swelling occur, your doctor may prescribe a steroid such as prednisone. Other medicines that reduce your body’s immune response, such as rituximab, may also provide relief.

Eye drops can relieve dry, gritty, irritated eyes.

Sunglasses can help with light sensitivity. Special eyeglass lenses may help reduce double vision. If you have puffy eyelids, your doctor may advise you to sleep with your head raised to reduce swelling. If your eyelids do not fully close, taping them shut at night can help prevent dry eyes.

Your doctor may recommend surgery to improve bulging of your eyes and correct the vision changes caused by pressure on the optic nerve. A procedure called orbital decompression makes the eye socket bigger and gives the eye room to sink back to a more normal position. Eyelid surgery can return retracted eyelids to their normal position.

Rarely, doctors treat Graves’ eye disease with radiation therapy to the muscles and tissues around the eyes.

What should I avoid eating if I have Graves’ disease?

People with Graves’ disease may be sensitive to harmful side effects from iodine. Eating foods that have large amounts of iodine—such as kelp, dulse, or other kinds of seaweed—may cause or worsen hyperthyroidism. Taking iodine supplements can have the same effect.

Talk with your health care professional about what foods you should limit or avoid, and let him or her know if you take iodine supplements. Also, share information about any cough syrups or multivitamins that you take because they may contain iodine.

Wendy Williams: Learning to Stay in Remission for Graves’ Disease

After a three-week medically mandated hiatus, to deal with her out of control hyperthyroidism, and diagnosis of Graves’ disease, Wendy Williams triumphantly returned to the Manhattan studio of her eponymous talk show to a standing ovation from an audience full of loyal fans. During that show, with guest Mehmet Oz, MD, Williams, who had been diagnosed with hyperthyroidism and Graves’ disease in 1999, explained what led up to her forced vacation.

Even though she hadn’t been feeling like herself for months, she’d canceled two or three appointments with her endocrinologist. Ignoring her body’s SOS, which was trying to warn her that her thyroid hormone levels were off the rails.

Wendy Williams is feeling great now that her hyperthyroid condition is back in check.

“I was a mess,” she said echoing what she’d told her audience when she announced that her doctor had insisted that she step away from her show for three weeks. “My thyroid has been totally catawampus,” she said. She ticked off other symptoms she’d been experiencing: irritability, anxiety, sleep troubles, and unplanned weight loss. She felt very out of sorts “like there are birds swimming around my head—you know like cartoon,” she said. And she explained as she has before, that Graves’ disease was the reason for her bulging eyes. Known as exophthalmos in medical parlance, this eye condition can be a telltale sign of this thyroid condition. “Scary stare” is how Williams describes it.

During her hiatus, she had a full medical workup and learned that in addition to her overactive thyroid, she had a serious vitamin D deficiency (the lowest level her doctors had ever seen, she said). While vitamin D deficiency is fairly common, affecting up to 70% of people in the United States by some estimates, in some people, it can lead to “mood problems,” Dr. Oz explained. To get her levels back to normal range, Williams is taking 50,000 units of supplemental vitamin D weekly.

The Lowdown on Hyperthyroidism

Hyperthyroidism is an endocrine disorder caused by an overproduction of thyroid hormone. When the thyroid gland is hyper- or overactive, the body’s processes speed up and this acceleration may cause nervousness, anxiety, rapid heartbeat, hand tremors, excessive sweating, weight and hair loss, and sleep problems, among other symptoms. “In addition, some individuals might experience problems with memory, focus, and depression,” says endocrinologist Angela Leung, MD, assistant professor of medicine David Geffen School of Medicine at the University of California/Los Angeles.

And while hyperthyroidism has a number of causes, the most common condition is Graves’ disease, an autoimmune disorder in which the body attacks the thyroid as it would a virus or bacteria. As a defense, this small butterfly-shaped gland that sits at the base of the throat fights back by overproducing the hormone thyroxine. If not treated, Graves’ disease can eventually cause heart damage, muscles aches, and erratic behavior due to negative effects on the brain.

Graves’ disease represents 50–80% of cases of hyperthyroidism. It runs in families and is more common in women than men.

The Course of Treatment for Hyperthyroid

The recommended treatment for hyperthyroidism “depends on the cause of the hyperthyroidism, as well as other factors such as the person’s age, other medical problems, size of the thyroid gland, and presence of any thyroid eye disease,” explains Dr. Leung, adding, “The goal of the treatment is decreasing the high levels of circulating thyroid hormone, as well as minimizing the effects of having too much thyroid hormone.” Treatment options include “oral medications such as methimazole and propylthiouracil that are effective in decreasing the production of thyroid hormone, but patients taking these should be aware of the potential side effects. Two other therapies, which are more permanent and will likely result in actual thyroid hormone underproduction, are a dose of radioactive iodine and/or thyroid surgery,” says Dr. Leung.

After her original diagnosis of Graves’ disease, Williams decided on a single dose of radioactive iodine taken orally to destroy the misbehaving thyroid cells. Afterward, she was allowed to go home but had to steer clear of other people–including her husband—for 48 hours to protect them from possible exposure to the radiation.

With this treatment, the thyroid often goes from overactive to underactive (hypothyroid) meaning it doesn’t produce an adequate amount of thyroid hormone. “It is possible that radioactive iodine is able to destroy the overactive parts of the thyroid gland to result in normal thyroid hormone levels, but frequently, the result is hypothyroidism,” says Dr. Leung. “Once hypothyroid, patients are required to take thyroid hormone replacement to maintain normal thyroid hormone levels,” she adds.

That’s what happened to Williams. Under the care of her endocrinologist, she was put on a daily dose of thyroid hormone. And for close to 20 years, all went well. Until recently, when it didn’t.

When Graves’ Disease Returns After Remission

While Wendy Williams didn’t share the specifics of her downward spiral, there are many reasons why someone’s thyroid levels might fluctuate, sometimes, as in Ms. Williams case, wildly.

Most people whose hyperthyroidism treatment leads to hypothyroid take levothyroxine, as Ms. Wililams has for years. It is possible that over time, or for a variety of reasons, her dose may have been too high and without regular check-ups and adjustments to her thyroid hormone medication, her thyroid levels likely continued to climb.

Other reasons that thyroid levels may rise: weight changes (she lost weight), hormonal shifts during menopause (she’s in perimenopause), taking hormone replacement therapy, change in medication (such as going from Synthroid to a generic brand or a different generic can cause levels to fluctuate because absorption rates and bioavailability vary among generics), dietary changes, taking vitamins or foods with iron or calcium at the same time as the levothyroxine is likely to interfere with thyroid hormone levels .

Other than speculating, there is no way to say exactly what might have caused Wendy Willams levels to go wonky.

Williams says that the “perfect storm” that led to her recent health crisis has been a wake-up call and a very clear reminder that like so many other women, she needs to pay attention to her body and make time to take care of her health. Now that she’s been given a stern warning from this health crisis, she won’t be skipping appointments with her endocrinologist or any of her other doctors. She hopes, too, that her experience helps to motivate other women to take control of their health and to resist the urge to ignore symptoms best brought to the attention of the doctor.

Williams appreciates the support she’s received from her fans, and the outpouring of concern they’ve shown toward her. And even though she’s famous for telling her audience how she feels about other people, pop culture, and celebrities, she’s asked her fans to refrain from asking her how she’s feeling. Her health status is now good with her hyperthyroidism and Graves’ disease under control. She’d like to get back to focusing on others rather than dwelling on her medical status.

Heed this warning—When You Don’t Feel Right, Call Your Doctor

Updated on: 04/16/18 Continue Reading Radioactive Iodine Considered Optimal For Graves’ Disease

Hyperthyroidism and Graves’ Disease

The best test to determine overall thyroid function is the thyroid stimulating hormone (TSH) level. TSH is produced in the brain and travels to the thyroid gland to stimulate the thyroid to produce and release more thyroid hormone. A high TSH level indicates that the body does not have enough thyroid hormone. A TSH level lower than normal indicates there is usually more than enough thyroid hormone in the body and may indicate hyperthyroidism. When hyperthyroidism develops, free thyroxine (T4) and free triiodothyronine (T3) levels rise above normal. Other laboratory studies may help identify the cause of hyperthyroidism. Thyroid-stimulating immunoglobulins (TSI) can be identified in the blood when Graves’ disease is the cause of hyperthyroidism. Thyroid peroxidase antibodies and other anti-thyroid antibodies are also seen in some disorders leading to hyperthyroidism.

Treatments for Hyperthyroidism

Currently, there are several effective treatments available for hyperthyroidism depending on the cause, severity, and several other factors. The most common treatments for hyperthyroidism include antithyroid medications, radioactive iodine, and thyroid surgery.

Antithyroid medication (most often methimazole) decreases thyroid hormone production. Antithyroid medicine does not cure the disease but works while the patient takes the medication. It is not usually recommended as a long term solution, although in some patients the hyperthyroidism does go into remission and the medication can be discontinued. If the hyperthyroidism does not go into remission after two years, a more definitive treatment is often recommended (thyroidectomy or radioactive iodine).

Radioactive iodine (RAI) is a common treatment for hyperthyroidism. The thyroid is one of the few organs in the body that avidly takes up iodine. This allows radioactive iodine to selectively damage the thyroid gland without affecting other parts of the body. The thyroid gland is eventually destroyed and disappears and the body no longer produces its own thyroid hormone. In general, this treatment can be used in patients with Graves’ disease or in those patients with nodules in the thyroid gland causing hyperthyroidism. Not all cases of hyperthyroidism respond well to radioactive iodine.

After radioactive iodine most patients will require thyroid hormone replacement with levothyroxine (Synthroid, Levothroid, and other brand names). Thyroid hormone levels will be checked frequently at the beginning, and then often are only checked once a year after the correct dose of thyroid hormone for the patient has been determined.

Some patients will have their hyperthyroidism treated by having part or all of their thyroid surgically removed.

Deciding which treatment for hyperthyroidism is the right treatment is made on a case by case basis according to each individual patient’s medical, social, and family history. Often, surgical thyroidectomy is recommended over RAI in the following circumstances:

  • Large thyroid causing compressive symptoms unlikely to be treated adequately with RAI
  • Significant compression of adjacent structures and compressive symptoms
  • Moderate to severe Graves’ eye disease
  • Failed medical therapy
  • Adverse reaction to antithyroid medications
  • Need for rapid reversal of hyperthyroidism
  • Fear of radiation exposure, inability to comply with radiation safety guidelines
  • Co-existent thyroid nodules and need to rule out possibility of thyroid cancer
  • Small children at home
  • Pregnancy, desire for pregnancy within next 4-6 months, or lactation
  • Patient desire

What’s Special About University of Michigan’s Treatment of Graves’ Disease?

UM is one of the few places in the country that has a multidisciplinary group dedicated to the treatment of patients with Graves’ disease. UM’s multidisciplinary group consists of endocrinologists, endocrine surgeons, ophthalmologists, nuclear medicine physicians, rheumatologists and psychiatric professionals. Our group sees Graves’ disease patients from around the country and is involved with one of the most well-known national organizations concentrating on helping patients and families coping with Graves’ disease and Graves’ eye disease. Our group routinely publishes papers with new research results on Graves’ disease.

The ophthalmologists in our group specialize in the treatment of Graves’ eye disease which can require complex management. Most ophthalmologists have little experience treating patients with Graves’ disease and Graves’ eye disease. For those patients with Graves’ eye disease, it is the severity of the eye disease which drives the selection of the type of treatment for hyperthyroidism if these two problems occur together.

While those patients with no Graves’ eye disease or only mild eye disease may be candidates for any of the three types of treatments for hyperthyroidism, those who have moderate to severe eye disease are often referred for surgical thyroidectomy as RAI has a higher chance of worsening the eye disease than surgery does.

Graves’ Disease Rarely Life-threatening But Can Lead to Heart Problems, Weak Bones

Graves’ Disease Rarely Life-threatening But Can Lead to Heart Problems, Weak Bones

August 26, 2011

Dear Mayo Clinic:

What can you tell me about Graves’ disease? I am a 33-year-old woman and was diagnosed last week, but had never heard of this condition before. How is it treated?

Answer:

Graves’ disease — a disorder in which the thyroid gland makes more thyroid hormone than the body needs — is the most common form of hyperthyroidism in the U.S. Although it can affect both women and men and occur at any age, the condition is five to 10 times more common in women and typically starts before age 40. Graves’ disease is rarely life-threatening. However, without treatment, it can lead to heart problems and weak and brittle bones.

Graves’ disease is known as an autoimmune disorder. That’s because with the disease, your immune system attacks your thyroid — a small, butterfly-shaped gland at the base of your neck. Antibodies called thyroid-stimulating immunoglobulins (TSI) then cause your thyroid to make excessive amounts of two thyroid hormones: triiodothyronine (T3) and thyroxine (T4).

These hormones help regulate your metabolism (how your body uses energy). However, when your body makes too much of them, many bodily functions can be kicked into overdrive — causing everything from sweating and a rapid heartbeat to sudden weight loss and fatigue.

Other signs and symptoms may include anxiety or nervousness, sleep difficulties, changes in menstrual cycles, frequent bowel movements and an enlarged thyroid gland (goiter). Some people also may develop Graves’ ophthalmopathy, a condition that causes redness and swelling around the eyes and bulging of the eyeballs within the eye sockets. Another potential, but uncommon, sign of Graves’ disease is thickening and reddening of the skin, typically on the shins.

It’s unclear why some people develop Graves’ disease. But being a woman in your reproductive years increases the risk. So does having a family history of the disease or having another autoimmune disorder — such as type 1 diabetes or rheumatoid arthritis.

To diagnose Graves’ disease, doctors commonly take a medical history, perform a physical exam, and order one or more lab tests. These tests may include thyroid function tests, a radioactive iodine uptake test or an antibody test.

The treatment goals for Graves’ disease are to inhibit production of thyroid hormones and lessen the severity of symptoms. There are several treatment options, including:

Anti-thyroid medications: These drugs, such as methimazole (Tapazole), keep the thyroid from making too much thyroid hormone. After one or two years of treatment, thyroid function may normalize in some people and result in a long-term remission of Graves’ disease. However, it’s common for the thyroid to become overactive once again after the drug is stopped. Therefore, these drugs may be used with, or followed by, another type of treatment.

Radioactive iodine therapy:This treatment uses radioactive iodine to destroy the thyroid’s ability to make thyroid hormones. Almost everyone who receives this treatment, which is swallowed as a liquid, develops an underactive thyroid (hypothyroidism) which is treated by taking synthetic thyroid hormone for life to replace what the thyroid can no longer make on its own. The radioactive iodine used for this therapy is considered a low-risk treatment for most adults. However, this therapy isn’t used in pregnant women or in women who are breast-feeding. This therapy may also not be recommended in some patients with Graves’ ophthalmopathy because studies have suggested that it could worsen this eye condition.

Surgery: With surgery, most or all of the thyroid gland is removed, and synthetic thyroid hormone typically must be taken for life. Surgery is a safe and effective treatment for Graves’ disease if performed by a surgeon who is very experienced in the procedure. It may be recommended if you can’t tolerate anti-thyroid drugs, have Graves’ ophthalmopathy or don’t have success with radioactive iodine treatment. Surgery is the best option if there’s any indication that you also have thyroid cancer. Graves’ disease doesn’t cause thyroid cancer, but this cancer can be present at the same time as the disorder.

In addition to one or more of these treatments, your doctor may recommend that you take a beta blocker until your other treatment becomes effective. This type of drug blocks some of the actions of thyroid hormone on your body. As a result, it can slow down your heart rate and effectively reduce some other symptoms of Graves’ disease, such as nervousness.

Because there are numerous treatment options, be sure to work closely with your doctor to determine which treatment will help you best manage the condition.

— Rebecca Bahn, M.D., Endocrinology, Mayo Clinic, Rochester, Minn.

Can I Get Disability for Graves’ Disease?

Graves’ disease is an endocrine disorder that involves the thyroid gland. It is the most common source of hyperthyroidism, the overproduction of thyroid hormones. It has been suggested that Graves’ disease is an autoimmune response to some type of virus, because it occurs suddenly and late in life. Women are eight times more likely to suffer from Graves’ Disease than men are. Most individuals who have Graves’ Disease are between 30 and 50, although it is not uncommon for younger and older individuals to have the disease.

Diagnosis, Symptoms, and Treatment

Graves’ disease can be diagnosed by testing thyroid hormone levels in the blood (thyroid stimulating hormone, or TSH). Symptoms of Graves’ disease include protruding eyeballs (Graves’ ophthalmopathy), a skin condition on the lower extremities that causes thick, red skin (Graves’ dermopathy), or a goiter (enlargement of the thyroid gland). Graves’ disease can also cause trouble sleeping, fatigue, an irregular heartbeat, and hand tremors. Treatment options for individuals with Graves’ Disease might involve anti-thyroid medications, surgical removal of the thyroid, and radioactive iodine treatment.

Does Graves’ Disease Qualify for Disability?

Most patients with Graves’ disease are able to treat and stabilize their condition without having to quit work. Some patients have a harder time, especially those with endocrine orbitopathy, which can include dry or tearing, bulging eyes, which can cause visual limitations. In addition, the cosmetic figurement caused by bulging eyes can cause some patients to be anxious and depressed.

The Social Security Administration (SSA) does not have a specific disability listing for Graves’ disease, so it’s not likely that you’ll win disability benefits for Graves’ disease alone. (Though you might be able to get benefits through amedical-vocational allowance.) And if you have other complications, the SSA will assess those medical conditions under the disability listing for that condition. For example, Graves’ disease can sometimes lead to increased heart rate, which can lead to cardiovascular damage, which is evaluated under the SSA’s cardiovascular listings. Similarly, Graves’ can lead to an increased risk of strokes, which are evaluated under the SSA’s listing for cerebrovascular disease, orcentral nervous system vascular accidents. And if Graves’ has caused severe anxiety or depression, the SSA will evaluate these problems under its mental disorders listing.

All about Graves’ disease

There are a variety of treatments available for Graves’ disease. The majority are aimed at inhibiting the overproduction of thyroid hormones by targeting the thyroid gland; others aim to reduce the symptoms.

Anti-thyroid medication

The most commonly utilized treatment for Graves’ disease anti-thyroid medication.

Three common drugs that target the thyroid are propylthiouracil,methimazole, and carbimazole (which is converted to methimazole and is not available in the United States but is used in Europe); methimazole is most common in the United States.

Anti-thyroid medication helps prevent the thyroid gland from producing excess amounts of hormones by blocking the oxidation of iodine in the thyroid gland.

Symptoms normally improve within 4-6 weeks of starting medication. Anti-thyroid drugs can often be used in conjunction with other treatments such as radioactive iodine therapy or surgery.

Medication may continue for 12-18 months to make sure that the condition does not come back. In some cases it may be prescribed longer.

Radioactive iodine therapy

Radioactive iodine therapy has been used to treat Graves’ disease since the 1940s. It is still popular because it is non-invasive and highly effective.

Radioactive iodine is taken orally and directly targets the thyroid gland. Iodine is used by the thyroid gland to make thyroid hormones. When medication is taken, the radioactive iodine soon builds up in the thyroid gland and slowly destroys any overactive thyroid cells.

This results in a reduction in size of the thyroid gland, and fewer thyroid hormones being produced. Although there have been concerns that the radiation might increase risk of thyroid cancer, so far, no study has measured an increased danger. However, there is a very small risk of secondary cancers that may result from this treatment.

Beta blockers

Beta blockers are traditionally prescribed to deal with heart problems and hypertension. They work by blocking the effects of adrenaline and other similar compounds. They can help reduce symptoms in Grave’s disease.

Graves’ disease patients may be more sensitive to adrenaline, this can result in symptoms such as sweating, shaking, increased heart rate, and anxiety. Beta blockers can help alleviate these symptoms, but do not address Graves’ disease itself.

Beta blockers are often used alongside other treatments, meaning there is a risk that side-effects can occur due to the different drugs interacting with one another.

Surgery

Because other treatments for Graves’ have steadily improved, surgery is now less common. However, it is still used if other treatments are unsuccessful.

Thyroidectomy is the removal of all or part of the thyroid gland – how much depends on the severity of the symptoms.

The biggest advantage of surgery is that it is arguably the fastest, most consistent, and most permanent way to restore normal thyroid hormone levels.

After surgery, patients may experience neck pain and a hoarse or weak voice, however, these should just be temporary, due to the breathing tube that is inserted into the windpipe during surgery.

A scar will be present after surgery, the severity of it will depend on how much of the thyroid is removed.

If only part of the thyroid is removed, the remaining portion is able to take over its functions.

If the whole thyroid is removed, the body will be unable to produce enough thyroid hormones, a condition known as hypothyroidism. To treat this, a doctor will prescribe hormone pills, which replace the effect of the hormone.

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