National Graves' Disease Foundation

Frequently Asked Questions
About Graves' Disease

 What is Graves' Disease?

The leading cause of hyperthyroidism, Graves' disease represents a basic defect in the immune system, causing production of immunoglobulins (antibodies) which stimulate and attack the thyroid gland, causing growth of the gland and overproduction of thyroid hormone. Similar antibodies may also attack the tissues in the eye muscles and in the pretibial skin (the skin on the front of the lower leg).

 Facts

• Graves' disease occurs in less that 1/4 of 1% of the population.
• Graves' disease is more prevalent among females than males.
• Graves' disease usually occurs in middle age, but also occurs in children and adolescents.
• Graves' disease is not curable, but is a completely treatable disease

 Symptoms

• Fatigue
• Weight Loss
• Restlessness
• Tachycardia (rapid heart beat)
• Changes in libido (sex drive)
• Muscle weakness
• Heat intolerance
• Tremors
• Enlarged thyroid gland
• Heart palpitations
• Increased sweating
• Blurred or double vision
• Nervousness & irritability
• Eye complaints, such as redness and swelling
• Hair changes
• Restless sleep
• Erratic behavior
• Increased appetite
• Distracted attention span
• Decrease in menstrual cycle
• Increased frequency of stools

 Who develops Graves' disease?

Although Graves' disease most frequently occurs in women in the middle decades (8:1 more than men), it also occurs in children and in the elderly. There are several elements contributing to the development of Graves' disease. There is a genetic predisposition to autoimmune disorders. Infections and stress play a part. Graves' disease may have its onset after an external stressor In other instances, it may follow a viral infection or pregnancy. Many times the exact cause of Graves' disease is simply not known. It is not contagious, although it has been known to occur coincidentially between husbands and wives. Of research importance, the Graves' gene in DNA has not yet been identified.

 How is Graves' disease treated?

There are three standard ways of treating Graves' disease. Choice of treatment varies to some degree from country to country, and among particular physicians as well. The decision should be made with the full knowledge and informed consent of the patient, who is the primary member of the treatment team. The selection of treatment will include factors such as age, degree of illness, and personal preferences. Generally speaking, from least invasive to most invasive, the treatments include:

1. Anti-thyroid drugs which inhibit production or conversion of the active thyroid hormone;
2. Radioactive iodine (I-131), which destroys part or all of the thyroid gland and renders it incapable of overproducing thyroid hormone; or
3. Subtotal thyroidectomy, in which a surgeon removes most of the thyroid gland and renders it incapable of overproducing thyroid hormone.

The first treatment is about 20-30% effective, and the latter two treatments result in about a 90-95% resolution rate of the disease. In a few cases, the treatments must be repeated. In all cases, lifetime follow-up laboratory studies must be done, and in almost all cases, lifetime replacement thyroid hormone must be taken.

 Are there any alternatives to these treatments of  Graves'  disease?

There are a number of things that you can do to assist your body in healing. However, the state of science as we know it indicates there is no "natural" way to "cure" Graves' disease. For instance, although there are no specific foods that will permanently change your thyroid function, the more healthy, nutritionally dense foods you eat, the better your body will be able to fight against infection and further insult. Equally, many of the treatments like acupuncture, exercise, meditation, and various mind-body therapies may provide comfort measures and relief, but are not a substitute for standard medical treatment. Be sure to consult and collaborate with your physician when embarking on additional therapies. There are many studies of other auto-immune diseases that indicate that the more input and control a patient has in their care, the more rapid their recovery will be. It is of interest to all who are hopeful of more, effective additional treatment models in the future that the National Institutes of Health are trying to adequately research and evaluate the hard data of alternative therapies.

 What are the complications?

Graves disease usually responds to treatment, and after the initial period of hyperthyroidism, is relatively easy for physicians to treat and manage. There are some exceptions to this, and for some, treatment and subsequent stabilization are much more challenging, both to the patient and the treating team of physicians. The more serious complications of prolonged, untreated, or improperly treated Graves' disease include weakened heart muscle leading to heart failure; osteoporosis, or possible severe emotional disorders.

 Where can I get more information?

The NGDF is a lay organization that provides patient education and support. Membership entitles you to our newsletter, bulletins, discounts at our annual national conference and contribute to the continuation and availablity of the Foundation to others with Graves' disease. All our materials are prepared by experts in their field, and carefully monitored for accuracy. The information is not a substitute for medical care. For more information, send a 9 X 12 --inch self addressed, stamped ($1.01) envelope. You will receive a sample newsletter, sample bulletins, a complete list of publications and applications. If you join now, please allow six to eight weeks for processing. All membership dues and contributions are tax-deductible.

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