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Graves disease: Causes, Symptoms, Treatment, and Cost

Last Updated: Jul 25, 2023

What is Graves disease?

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The exact cause of Graves' disease is unknown, but several factors are believed to play a role in its development, including:

  • Genetics: Graves' disease tends to run in families, and individuals with a family history of the disease are more likely to develop it.
  • Autoimmune response: In Graves' disease, the thyroid gland is stimulated to create excessive levels of thyroid hormones, which results in hyperthyroidism.
  • Gender and age: Women are more often affected by Graves' illness than males, and it commonly strikes them between the ages of 20 and 40.
  • Stress: Stress, whether it be physical or emotional, may cause Graves' disease to manifest or worsen its symptoms.
  • Smoking: Smoking has been connected to a higher chance of getting Graves' disease as well as symptoms becoming worse.
  • Infections: Certain viral or bacterial infections have been associated with the development of Graves' disease.
  • Other autoimmune disorders: Graves' illness is more likely to affect those with other autoimmune diseases like type 1 diabetes or rheumatoid arthritis.

What causes Graves disease?

The exact cause of Graves' disease is unknown, but several factors are believed to play a role in its development, including:

  • Genetics: Graves' disease tends to run in families, and individuals with a family history of the disease are more likely to develop it.
  • Autoimmune response: In Graves' disease, the thyroid gland is stimulated to create excessive levels of thyroid hormones, which results in hyperthyroidism.
  • Gender and age: Women are more often affected by Graves' illness than males, and it commonly strikes them between the ages of 20 and 40.
  • Stress: Stress, whether it be physical or emotional, may cause Graves' disease to manifest or worsen its symptoms.
  • Smoking: Smoking has been connected to a higher chance of getting Graves' disease as well as symptoms becoming worse.
  • Infections: Certain viral or bacterial infections have been associated with the development of Graves' disease.
  • Other autoimmune disorders: Graves' illness is more likely to affect those with other autoimmune diseases like type 1 diabetes or rheumatoid arthritis.

What are the symptoms of Graves disease?

Certainly, here are the symptoms of Graves' disease along with a brief explanation:

  • Anxiety and irritability: People with Graves' disease may feel restless, nervous, and have trouble concentrating.
  • Weight loss despite an increased appetite: People can lose weight even when their hunger has increased.
  • Heat intolerance and increased sweating: They may feel hot and sweat excessively, even in cool temperatures.
  • Tremors or shaking: They may experience shaking or trembling in their hands, fingers, or other parts of the body.
  • Rapid or irregular heartbeat (palpitations): They may experience a rapid or irregular heartbeat or palpitations.
  • Increased bowel movements or diarrhea: They can have diarrhea or frequent bowel motions.
  • Fatigue and muscle weakness: They may feel tired and weak, even if they have not been doing any physical activity.
  • Changes in menstrual cycles: Menstrual periods or flow alterations may be irregular in women with Graves' illness.
  • Difficulty sleeping: They can have a hard time falling or staying asleep.
  • Bulging of the eyes (Graves' ophthalmopathy): Some people with Graves' disease may develop bulging of the eyes, redness, or swelling. This condition is known as Graves ophthalmopathy.

How can you prevent Graves disease?

There are several prevention methods for Graves' disease, which include:

  • Avoiding radiation exposure: Radiation exposure can cause thyroid dysfunction and increase the risk of developing Graves' disease, so it is important to limit radiation exposure.
  • Maintaining a balanced diet: A nutritious diet full of fruits, vegetables, and whole grains helps support immune system function and lower the chance of developing Graves' disease.
  • Quitting smoking: Smoking can significantly increase the risk of developing Graves' disease and can also worsen the symptoms in those who are already affected.
  • Reducing stress: Stress can cause the immune system to malfunction and increase the risk of developing autoimmune diseases such as Graves' disease. Managing stress through meditation, exercise, or counseling can help reduce the risk.
  • Regular check-ups: Frequent check-ups with your doctor may help identify thyroid malfunction early and stop Graves' disease from progressing.

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Graves disease - Diagnosis and Tests

The following are the diagnostic tests used for Graves' disease:

  • Thyroid-stimulating hormone (TSH) test: The pituitary gland releases TSH, a hormone that prompts the thyroid to create thyroid hormones. In Graves' disease, the TSH level is low because the overactive thyroid gland produces enough thyroid hormones, making the pituitary gland produce less TSH.
  • Free thyroxine (FT4) and triiodothyronine (FT3) tests: These examinations evaluate the blood's thyroid hormone levels. Both FT4 and FT3 levels are increased in Graves' illness as a result of the thyroid gland producing excessive amounts of thyroid hormones.
  • Thyroid autoantibody tests: The presence of thyroid autoantibodies indicates an autoimmune disorder affecting the thyroid gland. The thyroid-stimulating immunoglobulin (TSI), which encourages the thyroid gland to create more thyroid hormones, is the most prevalent autoantibody in Graves' illness.
  • Radioactive iodine uptake test (RAIU): The thyroid gland's ability to absorb radioactive iodine is determined by this test. In Graves' disease, the uptake is increased due to the overactive thyroid gland producing more thyroid hormones.
  • Thyroid ultrasound: In this imaging procedure, the thyroid gland is seen using sound waves. It can detect the enlargement of the thyroid gland, which is a common sign of Graves' disease.
  • Fine-needle aspiration biopsy (FNAB): A tiny sample of thyroid tissue is removed for this test and examined under a microscope. It can help determine if a nodule in the thyroid gland is cancerous or not.

What are the possible complications of Graves disease?

The following are the complications of Graves' disease:

  • Hyperthyroidism: Graves disease is an autoimmune condition that causes excessive thyroid hormone production, which results in hyperthyroidism. Weight loss, an accelerated pulse, tremors, and anxiety are symptoms.
  • Thyroid eye disease: Also known as Graves' ophthalmopathy, this condition is characterized by inflammation of the eye muscles and tissues, leading to bulging eyes, double vision, and eye pain.
  • Pretibial myxedema: This is a rare complication of Graves disease that causes thickening and swelling of the skin on the shins, resulting in a lumpy appearance.
  • Thyroid storm: In rare cases, Graves disease can trigger a life-threatening condition called thyroid storm, which is characterized by high fever, rapid heartbeat, and confusion.
  • Osteoporosis: Hyperthyroidism caused by Graves disease can lead to bone loss and increase the risk of fractures.
  • Cardiovascular problems: Heart problems, including high blood pressure, heart palpitations, and arrhythmias, are all made more likely by hyperthyroidism.
  • Pregnancy complications: Women with Graves disease who become pregnant may experience complications such as preterm labor, preeclampsia, and fetal growth restriction.
  • Mental health issues: Because of the hormonal imbalances that Graves disease produces, may lead to anxiety, sadness, and other mental health issues.
  • Thyroid cancer: Despite its rarity, Graves disease sometimes raises the risk of thyroid cancer.

Home Remedies for Graves disease?

Here the best ayurvedic and safe remedies which can I used at home are listed:

  • Ashwagandha: This plant has a reputation for lowering stress and anxiety levels, which may aid in managing Graves disease symptoms.
  • Triphala: A mix of three fruits, this remedy is known for its detoxifying properties and can help eliminate toxins from the body.
  • Guggulu: This herb is known to balance the thyroid gland and can help regulate metabolism in the body.
  • Brahmi: This herb can help improve cognitive function and may help reduce symptoms of Graves disease such as brain fog and fatigue.
  • Shankhapushpi: This herb is understood to soothe the nervous system and lower levels of tension and anxiety in the body.
  • Amla: A rich source of Vitamin C, Amla can help boost immunity and may help reduce inflammation in the body.
  • Ginger: This root can help reduce inflammation in the body and may help alleviate symptoms such as joint pain and swelling.
  • Turmeric: This spice is well recognized for having anti-inflammatory effects, which may aid to lessen thyroid gland irritation.
  • Tulsi: This herb is known to boost immunity and can help fight off infections that may exacerbate Graves disease symptoms.
  • Licorice root: This herb is known to regulate the adrenal glands and may help reduce stress levels in the body.

What to eat for Graves disease?

These foods should be used when you are suffering from Graves disease:

  • Fruits, vegetables, and whole grains are anti-inflammatory foods that may help decrease inflammation and enhance general health.
  • High-fiber foods may facilitate regular bowel motions and lessen constipation, which may be a sign of Graves disease.
  • Lean proteins like chicken, fish, and lentils may improve thyroid function and assist in maintaining muscle mass.
  • Bone health, which may be impacted by hyperthyroidism, can be maintained by eating foods rich in calcium and vitamin D.
  • Processed meals and foods with a lot of sugar should be avoided since they might increase Graves disease symptoms by causing inflammation.

What not to eat for Graves disease?

This food should be avoided when you are suffering from Graves disease:

  • Processed Foods: Processed foods have high levels of sodium and artificial additives that can exacerbate the symptoms of Graves' disease. As a result, it is advised to stay away from things like canned goods, snacks, fast food, and frozen dinners.
  • Iodine-Rich Foods: Since Graves' disease is caused by the overproduction of thyroid hormones, consuming iodine-rich foods such as iodized salt, seaweed, and seafood can worsen the condition. To assist control the symptoms, it is crucial to restrict or avoid certain foods.
  • Caffeine and Alcohol: Caffeine and alcohol both affect how hormones are produced, making Graves' disease symptoms worse. It is recommended to avoid or limit the consumption of caffeinated drinks such as tea, coffee, and soda and alcoholic beverages such as beer and wine.
  • Goitrogenic Foods: Goitrogenic foods are those that can interfere with thyroid hormone production and aggravate Graves' disease symptoms. Such foods include broccoli, cabbage, cauliflower, kale, and spinach. It is recommended to cook such foods before consumption to reduce the goitrogenic effects.

Graves disease Treatment

These are the best treatment for Grave diseases:

  • Radioactive iodine therapy: Another treatment option for Graves' disease is radioactive iodine therapy, which involves the use of a radioactive form of iodine to destroy the thyroid gland. This procedure is effective in reducing the production of thyroid hormones and can be done as an outpatient procedure.
  • Thyroidectomy: With this surgical treatment, the thyroid gland is entirely removed. Those with severe symptoms or those who don't react to other therapies are often advised to use them. To keep their thyroids functioning normally after surgery, patients must take thyroid hormone replacement therapy for the remainder of their lives.
  • Radioactive iodine therapy: With this procedure, radioactive iodine is given orally in a way that specifically targets and kills thyroid cells. Patients must undergo thyroid hormone replacement therapy following therapy and may have adverse effects such as thyroid swelling or pain.
  • Partial thyroidectomy: With this procedure, the thyroid gland is only partially removed, preserving some of the healthy tissue. Those with a modest goiter or those whose condition is mostly stable are often advised to do this.
  • Endoscopic thyroidectomy: This is a minimally invasive surgery in which the thyroid gland is removed with the aid of a small, flexible endoscope. This technique produces less visible scarring and has a shorter recovery time than traditional thyroidectomy.

Which doctor to consult for Graves disease?

These are the best doctor to consult for Graves Disease:

  • Endocrinologist - An endocrinologist is a medical professional who focuses on the identification and management of diseases that affect the glands and hormones in the body and are connected to hormones. A hormonal condition known as Graves' disease causes an excessive amount of thyroid hormone to be produced, which damages the thyroid gland.
  • Ophthalmologist - An eye and vision specialist is known as an ophthalmologist. Graves' disease can cause eye problems, such as bulging eyes (proptosis), double vision, and eye pain.
  • Rheumatologist - Rheumatologists are experts in the identification and management of autoimmune diseases. An autoimmune condition called Graves' disease results in an overactive thyroid.
  • Primary care physician - a primary care physician is typically the first point of contact for most individuals with health concerns. They will conduct a physical examination and refer patients to necessary specialists for further evaluation and care.
  • Surgeon - Surgery to remove the thyroid gland may be indicated in rare instances of severe Graves' illness (thyroidectomy).
  • Mental Health Professional - Anxiety, despair, and other psychiatric symptoms are some of the effects Graves' illness may have on mental health and well-being. Consulting a mental health professional for support and treatment can be beneficial.

Which doctor to consult for Graves disease?

These are the best doctor to consult for Graves Disease:

  • Endocrinologist - An endocrinologist is a medical professional who focuses on the identification and management of diseases that affect the glands and hormones in the body and are connected to hormones. A hormonal condition known as Graves' disease causes an excessive amount of thyroid hormone to be produced, which damages the thyroid gland.
  • Ophthalmologist - An eye and vision specialist is known as an ophthalmologist. Graves' disease can cause eye problems, such as bulging eyes (proptosis), double vision, and eye pain.
  • Rheumatologist - Rheumatologists are experts in the identification and management of autoimmune diseases. An autoimmune condition called Graves' disease results in an overactive thyroid.
  • Primary care physician - a primary care physician is typically the first point of contact for most individuals with health concerns. They will conduct a physical examination and refer patients to necessary specialists for further evaluation and care.
  • Surgeon - Surgery to remove the thyroid gland may be indicated in rare instances of severe Graves' illness (thyroidectomy).
  • Mental Health Professional - Anxiety, despair, and other psychiatric symptoms are some of the effects Graves' illness may have on mental health and well-being. Consulting a mental health professional for support and treatment can be beneficial.

Which are the best medicines for Graves disease?

The best medicines for Graves disease are listed below:

  • Antithyroid Drugs: Methimazole, Propylthiouracil (PTU), and Carbimazole. These medications are used to decrease the synthesis of thyroid hormones.
  • Beta Blockers: Metoprolol, propranolol, and atenolol. These medications aid in the management of Graves disease symptoms including anxiety, tremors, and a fast heartbeat.
  • Radioactive Iodine: This drug is used to destroy the overactive thyroid cells, which leads to the reduction of thyroid hormone levels.
  • Immunomodulators: Rituximab, intravenous immunoglobulin (IVIG), and plasmapheresis. These drugs are used to treat Graves disease when it is associated with other autoimmune disorders or when other treatments have been unsuccessful.

How long does it take to recover from Graves disease?

Metoprolol, propranolol, and atenolol. These medications aid in the management of Graves disease symptoms including anxiety, tremors, and a fast heartbeat. In some cases, the condition may recur even after successful treatment, requiring ongoing monitoring and management.

Are the results of the treatment permanent?

The results of surgery for Graves disease can be permanent, providing relief from the symptoms of the condition.

Which are the best medicines for Graves disease?

The best medicines for Graves disease are listed below:

  • Antithyroid Drugs: Methimazole, Propylthiouracil (PTU), and Carbimazole. These medications are used to decrease the synthesis of thyroid hormones.
  • Beta Blockers: Metoprolol, propranolol, and atenolol. These medications aid in the management of Graves disease symptoms including anxiety, tremors, and a fast heartbeat.
  • Radioactive Iodine: This drug is used to destroy the overactive thyroid cells, which leads to the reduction of thyroid hormone levels.
  • Immunomodulators: Rituximab, intravenous immunoglobulin (IVIG), and plasmapheresis. These drugs are used to treat Graves disease when it is associated with other autoimmune disorders or when other treatments have been unsuccessful.

What are the side effects of Graves disease treatments?

The treatment for Graves disease may have the following side effects:

  • Radioactive iodine therapy (RAI): Some patients may experience mild discomfort in the neck region, nausea, vomiting, or dryness of the eyes and mouth.
  • Antithyroid medication: Some patients may experience rashes, itching, joint pain, liver problems, or decreased white blood cell count.
  • Surgery: Some patients may experience pain, swelling, hoarseness, difficulty swallowing, or damage to the parathyroid glands.
  • Beta-blockers: Some patients may experience fatigue, weakness, dizziness, or low blood pressure.

Graves disease - Outlook and Prognosis

If you have Graves disease consequences, such as pretibial myxedema, osteoporosis, thyroid eye disease, etc., you should see a doctor in your area every once. Depending on the severity of the condition, treatment regimens may last anywhere from a few months to years.

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Written ByDrx Hina FirdousPhD (Pharmacology) Pursuing, M.Pharma (Pharmacology), B.Pharma - Certificate in Nutrition and Child CarePharmacology
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Reviewed ByDr. Bhupindera Jaswant SinghMD - Consultant PhysicianGeneral Physician
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