Graves’ Disease

Graves’ disease, also known as toxic diffuse goiter, is the most common cause of hyperthyroidism in the United States. Graves’ disease is an autoimmune disorder, meaning the body’s immune system acts its own healthy cells and tissues. In this case, your immune system attacks your hormone-producing capabilities.

Causes and Risk Factors for Graves’ Disease

Scientists don’t know exactly what causes Graves’ disease, but they believe factors such as age, sex, heredity, and emotional and environmental stress are involved. Graves’ disease usually occurs in people younger than age 40 and is 5-10 times more common in women than men. An individual’s chance of developing Graves’ disease increases if other family members have it. People with other autoimmune diseases have an increased chance of developing Graves’ disease. Type 1 diabetes, rheumatoid arthritis, and vitiligo (a disorder in which some parts of the skin lack pigment) are among conditions associated with Graves’ disease. 

Signs and Symptoms of Graves’ Disease

Graves’ disease shares some of the same symptoms as hyperthyroidism, which include the following:

  • Fatigue or muscle weakness
  • Frequent bowel movements or diarrhea
  • Goiter (an enlarged thyroid that may cause the neck to swell or bulge)
  • Hand tremors
  • Heat intolerance
  • Nervousness or irritability
  • Rapid and irregular heartbeat
  • Trouble sleeping
  • Weight loss 

In addition, the eyes of people with Graves’ disease may appear enlarged because their eyelids are retracted and their eyes bulge out from the eye sockets. This condition is called Graves’ ophthalmopathy. A small number of people with Graves’ disease also experience thickening and reddening of the skin on their shins. This usually painless problem is called pretibial myxedema or Graves’ dermopathy. Graves’ disease does not cause cancer. 

Diagnosis and Treatment of Graves’ Disease

Doctors can sometimes diagnose Graves’ disease based only on a physical examination and medical history. Laboratory tests confirm the diagnosis. Doctors may prescribe one or more of three treatment options:

  • Radioiodine therapy
  • Antithyroid drugs
  • Thyroid surgery 

Radioiodine therapy is the most commonly used treatment for Graves’ disease in the United States. Surgery is the least-often used. Doctors sometimes choose surgery to treat pregnant women who cannot tolerate antithyroid drugs, people in whom thyroid cancer is suspected, or those who fail other forms of treatment. When surgery is used, many doctors recommend the entire thyroid be removed, thereby eliminating the chance that hyperthyroidism will return. If the entire thyroid is removed, lifelong thyroid hormone replacement is necessary. 

Schedule a Thyroid Consult/Appointment

Patients with diseases of the thyroid and parathyroid come to the Mount Sinai Health System in New York City from all over the world. We provide comprehensive state-of-the-art care based on the latest innovations in the field. Our surgeons are internationally recognized as experts who excel in clinical care and research.

To schedule an appointment, call us at 212-241-9410. You may also request an appointment online or request  a telemedicine appointment by emailing