Your thyroid is a small butterfly-shaped gland in your neck that produces and releases hormones. These hormones help regulate many important body functions such as metabolism and body temperature.
If your thyroid doesn’t function properly, you may develop a thyroid disorder such as Graves’ disease.
“Women are more likely to develop Graves’ disease than men, and we see all age groups,” said Malini Gupta, MD, ECNU, FACE, FITS, endocrinologist and director of G2Endo.
We asked Gupta what women need to know about Graves’ disease and treatment options for the condition.
What is Graves’ disease?
Graves’ disease is an autoimmune disease in which antibodies mistakenly attack the healthy thyroid. The inflammation and damage caused by antibodies can cause your body to produce more thyroid hormones than it needs, which is called hyperthyroidism. Graves’ disease is the most common form of hyperthyroidism.
What are the symptoms of Graves’ disease?
Graves’ disease can cause a variety of symptoms that can affect your quality of life, daily functioning, and mental health, including:
- Feeling nervous, jittery, or irritable
- Trembling in the hands
- Heat intolerance, increased sweating, or the feeling of having moist, hot skin
- Weight loss/loss of appetite
- Changes in your menstrual cycles
- Changes in libido
- Sleep disorders
- Increased bowel movements
- fatigue
- Fast or irregular heartbeat or an irregular heartbeat
- Thickening of the skin
- Enlargement of the fingertips
- Hair loss
- Nail changes
- Increased wheezing or worsening of asthma
- Hearing loss or ringing in the ears
- Enlargement of the thyroid gland
About 4 in 10 people with Graves’ disease have a separate but closely related autoimmune disorder called thyroid eye disease, which can cause bulging, watery, and red eyes.
How do you know if you have Graves’ disease?
A doctor can do a simple blood test that can tell you whether you have hyperthyroidism. Antibody testing and sometimes a nuclear medicine test called a thyroid scan and scan will help your healthcare team determine whether you have Graves’ disease.
After you have been diagnosed with Graves’ disease, your primary care doctor will refer you to an endocrinologist, who usually specializes in thyroid disorders, to monitor your thyroid levels and guide treatment.
What treatments are used for Graves’ disease?
There are currently three traditional treatment options for Graves’ disease: oral antithyroid medications, radioactive iodine, and surgery. These options target the thyroid to stabilize hormone levels rather than addressing the underlying autoimmune cause of Graves’ disease.
Methimazole (MMI) and propylthiouracil (PTU) are the two most common oral thyroid medications that block the production of thyroid hormones in the gland.
Radioactive iodine (RAI) is another oral medication used to slowly destroy the cells that produce thyroid hormones. And sometimes a thyroidectomy, or surgical removal of the thyroid, plays a role in treatment. Both RAI and a thyroidectomy result in lifelong hypothyroidism (too little thyroid hormone) and require someone to take thyroid hormone medication for the rest of their life.
There are also new medications in clinical trials that are designed to address the root cause of Graves’ disease. They could provide a new option for people who have difficulty maintaining control
Read: Treatment options for Graves’ disease at a glance >>
How do you know if your Graves’ disease treatment is working?
You will often know your Graves’ disease treatment is working when your thyroid levels and symptoms improve. However, many people experience a relapse after taking thyroid medication for a period of time or after stopping the medication. If this occurs, you may need a different thyroid medication or treatment.
What should you do if you continue to have symptoms while treating Graves’ disease?
If you still have symptoms during treatment for Graves’ disease, even if your levels improve, it is important to talk to your doctor as you may need secondary treatment. This may mean you may be given heart medication to keep your heart rate down, an inhaler to help with breathing, or even acne medication.
Sometimes taking too much thyroid medication can lead to a condition called iatrogenic hypothyroidism, in which a person develops symptoms and levels of hypothyroidism and the thyroid dosage needs to be adjusted.
If Graves’ disease is not treated, it can cause heart failure, loss of bone density and, in severe cases, thyroid storm, a hormonal surge that can be fatal.
This educational resource was created with support from Immunovant, a member of the HealthyWomen Corporate Advisory Council.
