From the Guidelines
Graves' disease is an autoimmune disorder that causes the thyroid gland to produce too much thyroid hormone (hyperthyroidism). It occurs when the immune system mistakenly produces antibodies called thyroid-stimulating immunoglobulins that attach to thyroid cells, causing them to overproduce thyroid hormones. Common symptoms include weight loss, rapid heartbeat, anxiety, tremors, heat sensitivity, bulging eyes (Graves' ophthalmopathy), and an enlarged thyroid gland (goiter).
Treatment Options
- Anti-thyroid medications like methimazole or propylthiouracil can be used to reduce thyroid hormone production, as stated in the American family physician study 1.
- Beta-blockers such as propranolol may be prescribed to manage symptoms like rapid heart rate and tremors.
- For long-term management, radioactive iodine therapy to destroy thyroid tissue or surgical removal of the thyroid (thyroidectomy) may be recommended.
Important Considerations
- Most patients require lifelong monitoring of thyroid function, and those who undergo radioactive iodine treatment or surgery typically need thyroid hormone replacement therapy afterward.
- Early diagnosis and treatment are important to prevent complications like heart problems, bone loss, and severe eye issues.
- According to the study 1, the goal is to maintain FT4 or FTI in the high-normal range using the lowest possible thioamide dosage, and measuring the FT4 or FTI every two to four weeks can be helpful.
- It is also important to note that suppression of fetal and neonatal thyroid function can occur with thioamide therapy for Graves' disease, but it is usually transient, and treatment is rarely required, as mentioned in the study 1.
From the FDA Drug Label
Propylthiouracil is a prescription medicine used to treat people who have Graves’ disease with hyperthyroidism or toxic multinodular goiter.
Graves' disease is not directly defined in the provided drug label, but it is mentioned as a condition for which Propylthiouracil is used, in combination with hyperthyroidism. 2
From the Research
Definition and Characteristics of Graves' Disease
- Graves' disease (GD) is an autoimmune disorder involving the thyroid gland, characterized by the presence of circulating autoantibodies that bind to and stimulate the thyroid hormone receptor (TSHR), resulting in hyperthyroidism and goiter 3.
- The disease can affect organs other than the thyroid, leading to extrathyroidal manifestations, including Graves' ophthalmopathy, dermopathy, and acropachy 3, 4.
- The exact etiology of GD remains unknown, but it is believed to result from a complex interaction between genetic susceptibility and environmental factors 3, 4.
Clinical Characteristics and Diagnosis
- Clinically, GD is characterized by the manifestations of thyrotoxicosis, as well as its extrathyroidal features when present 3.
- The diagnosis is generally based on the association of hyperthyroidism and usually diffuse goiter confirmed with serum anti-TSHR autoantibodies (TRAbs) 3.
- Hyperthyroidism is a key feature of GD, and its treatment is crucial for managing the disease 5, 6.
Treatment Options
- Treatment of GD relies on antithyroid drugs (ATDs), radioactive iodine (RAI), and thyroidectomy 7, 6.
- ATDs are the first-line treatment worldwide, but they have a high recurrence rate after treatment 7.
- RAI is safe, but it can cause permanent hypothyroidism and has a low risk of GO progression, particularly in smokers 7.
- Thyroidectomy requires skilled and high-volume surgeons and can result in hypoparathyroidism or laryngeal nerve damage 7, 4.