Graves’ Disease: What Patients Need to Know.

What do music artist Missy Elliot and Olympic gold medalist Gail Devers have in common? Besides being successful public figures, they’ve both battled a common enemy. At the peak of their careers, they were diagnosed with Graves’ disease—an autoimmune disorder of the thyroid gland that can impact overall health and productivity. Despite this diagnosis, they stayed in the game, delivering chart-topping hits and winning medals on the track.

You or your loved one can bounce back too, with a little help from your medical team. Let’s look at what Graves’ disease is and the signs to watch for.

What is Graves’ disease?

Graves’ disease is a condition in which the body’s immune system mistakenly attacks the thyroid gland. As a result of this attack, the gland produces an excess of thyroid hormone, causing hyperthyroidism. Hyperthyroidism negatively impacts overall health.

As the most common cause of hyperthyroidism, the disease affects approximately 1% of the population, with a higher incidence in women of reproductive age. However, it can occur in males and females at any age.

What signs should you look for?

We still do not know the exact cause behind this illness, but common signs and symptoms might include some of the following:

• • Heart palpitations
  • Unusual weight loss
  • Excessive sweating
  • New-onset anxiety
  • Weakness
  • Fullness in the neck
  • Changes in the appearance of your eyes

How is it diagnosed and treated?

If a patient exhibits symptoms of hyperthyroidism, we usually prescribe specific blood tests and imaging to check for Graves’ disease or other conditions. There are two types of treatment options to control an overactive thyroid gland:

Anti-thyroid medications: As an initial measure, medications are prescribed to lower the levels of thyroid hormone and maintain normal metabolism and bodily functions. However, this is not a long-term solution since the hyperthyroidism returns in most people with Graves’ disease after stopping the medication.

The downside of using medications is that prolonged use may further impact overall health by causing side effects to the liver and bone marrow.

Definitive treatment: Long-term interventions include radioactive iodine therapy, which destroys the thyroid gland with radiation, or surgery to remove the thyroid gland to stop production of the hormone.

Radioactive iodine takes around three months to show results and may require repeated treatments to take effect. Some patients, after radioactive iodine therapy, will have to take supplemental thyroid hormone.

We recommend surgery over radioactive iodine for patients who:

• • • • Are trying to get pregnant or are breastfeeding
      • Have multiple nodules inside the thyroid gland
      • Already have eye disease due to Graves’ disease
      • Don’t want to undergo radiation therapy
      • Have other medical reasons why radioactive iodine therapy would not be in the patient’s best interest

It is important to have a discussion with your physician to choose the right treatment.

What is recovery after surgery like?

It typically takes just one to two weeks to recover from surgery under general anesthesia. You can resume normal activities as soon as you feel better.

After successful removal of the thyroid gland, the thyroid hormone is not produced in the body anymore, so the chance of Graves’ disease returning is very low. Because the thyroid is not present and making hormone anymore after surgery, you will need to take a thyroid supplement, which is safer and easier to manage than anti-thyroid medications.

Can complications occur if it’s left untreated?

If you don’t have any symptoms and a routine blood test indicates hyperthyroidism, don’t be surprised. During early onset, there are often no symptoms. Over time, however, it can have a negative impact on the heart, muscles, bones and eyes. One-third of patients develop bulging eyes due to fibrosis. So, it’s important to have routine checkups and look for unusual signs.

Graves’ disease is a lot more common than you think.

Schedule regular checkups with your doctor and keep track of your thyroid hormone levels. Early detection, timely treatment and post-surgery management go a long way to ensuring a quick recovery.

LISTEN: Dr. Lai discusses Graves’ disease in the Medical Intel podcast.