Like Hashimoto’s thyroiditis, Graves’ disease is an autoimmune disease that leads to a generalised overactivity of the entire thyroid gland. ¹ About 25–40% of Graves’ disease patients show signs of a clinically relevant Graves’ ophthalmopathy (inflammation and bulging of the eyes).³ However, Graves’ disease accompanied by moderate to severe Graves’ ophthalmopathy, only occurs in fewer than 5% of patients.²

Who is at risk?

Women under 40 years of age are especially prone to developing Graves’ disease.³ Smokers are more likely to have Graves’ disease and are more likely to have eye problems than non-smokers.³

Symptoms of Graves’ disease

This disease can go unnoticed for a long time, but you may experience some of the following symptoms:^1,4

• Fast heart rate
• Nervousness and/or irritability
• Anxiety
• Difficulty sleeping
• Weight loss without dietary change
• Muscle weakness, especially of the upper arms and thighs
• Increased sweating
• Frequent bowel movements
• Lighter or less frequent menstrual periods
• Trembling hands
• Thinning of the skin   
• Fine brittle hair

Symptoms of Graves’ ophthalmopathy include:¹

• Red or inflamed eyes
• Tissue swelling around the eyes
• Bulging eyes
• Very rarely, diminished or double vision

Diagnosing Graves’ disease

Your doctor cannot tell from the symptoms alone whether you have Graves’ disease. Physical examinations and blood tests are needed for a definite diagnosis.¹ Indicators include low levels of TSH and elevated levels of free thyroxine.⁵ In order to determine the extent of your hyperthyroidism, a triiodothyronine test will also be performed. If hyperthyroidism, enlarged thyroid gland, and eye problems described above coexist, the diagnosis of Graves’ disease appears self-evident.⁵

Treatment of Graves’ disease

Your doctor will discuss with you the best treatment options to prevent the thyroid gland from producing excess thyroid hormones.

• Anti-thyroid drugs allow control of hyperthyroidism by inhibiting the thyroid hormones’ synthesis in thyroid glands. They should be taken for at least 6 months to 2 years .⁵ In a small number of patients, the disease may permanently resolve.⁵
• Destroying thyroid tissue by radioactive iodine radiation is another option, but it will take 6–18 weeks before the benefit is reached.⁵
• The third option is to remove parts of or the whole thyroid gland by surgery.⁵

The last two options may provoke hypothyroidism in the long run.⁵ Your thyroid hormone levels will then be restored to normal by taking appropriate medication.¹ If you suffer from the symptoms of Graves’ disease (such as fast heart rate, anxiety, heat intolerance and trembling hands) then your doctor may temporarily prescribe beta-blockers, which will make you feel better within a short time.^4,5 Regular check-ups guarantee long-lasting treatment success¹.

Useful websites

 http://www.thyroid.org

Patient information on thyroid health published by the American Thyroid Association.

www.thyroid-fed.org

Patient information from Thyroid Federation International.

www.merckserono.de

Therapiegebiete/Endokrinologische Erkrankungen/Schilddrüse/Broschüren „Ihr Hashimoto Ratgeber“ und „Ihr Basedow Ratgeber“

GL-NONE-00102

Date of preparation: February 2022