Graves' disease

Graves' disease is a form of hyperthyroidism where the thyroid gland is ‘overactive’ and produces too much thyroid hormone. It is caused when the body’s immune system produce antibodies that disrupt the thyroid and cause it to make too much thyroid hormone (thyroxine).

How is Graves' disease diagnosed?

It is diagnosed with blood tests looking at the concentrations of thyroid hormones as well as the antibodies causing the thyroid gland to be overactive.

What are the symptoms of Graves' disease?

Due to the overactivity of the thyroid gland, various metabolic processes "speed up", and patients may have a fast heart rate (palpitations), diarrhoea, tremor, difficulties sleeping, weight loss, irregular periods, and feel hot, hungry or anxious. Younger children may be hyperactive, whilst older girls may have irregular periods. Some patients may have a neck swelling (goitre) or bulging eyes (Graves' ophthalmopathy).

How is Graves' disease treated and what are the side effects?

Treatment usually starts with an antithyroid drug called carbimazole. This drug is very effective and can be taken for many years. It has a very rare side effect that lowers the number of neutrophils (white blood cells that fight bacterial infection). For this reason, it is advised that anyone taking this medicine who develops a sore through, fever, rash or mouth ulcers should go to their GP or A&E the same day to be reviewed and to have a blood test.

In some young people, the Graves' disease runs its course in a few years and the thyroid recovers. In others treatment needs to continue either with carbimazole or by having the thyroid gland removed by surgery (thyroidectomy) or by radioctive iodine. In the these cases, lifetime treatment with thyroxine replacement tablets is required.