From the Guidelines
Graves' disease is an autoimmune disorder that causes overproduction of thyroid hormones, leading to hyperthyroidism, and is characterized by an enlarged thyroid gland, rapid heartbeat, weight loss, and sometimes bulging eyes (Graves' ophthalmopathy). Diagnosis typically involves blood tests for thyroid hormones (TSH, T3, T4) and thyroid antibodies, along with a physical examination and possibly thyroid imaging.
Key Characteristics
- Autoimmune disorder
- Overproduction of thyroid hormones
- Hyperthyroidism
- Enlarged thyroid gland
- Rapid heartbeat
- Weight loss
- Bulging eyes (Graves' ophthalmopathy)
Treatment
Treatment usually begins with antithyroid medications, most commonly methimazole (starting dose 10-30 mg daily) or propylthiouracil (50-150 mg three times daily) 1. These drugs reduce thyroid hormone production and are typically used for 12-18 months. Beta-blockers like propranolol (20-40 mg 3-4 times daily) may be prescribed to manage symptoms such as rapid heart rate and tremors.
Additional Considerations
For patients who don't respond to or can't tolerate medication, radioactive iodine therapy or thyroid surgery (thyroidectomy) may be recommended 1. These treatments often result in hypothyroidism, requiring lifelong thyroid hormone replacement with levothyroxine. Physical examination findings of ophthalmopathy or thyroid bruit are diagnostic of Graves' disease and should prompt early endocrine referral 1.
Disease Mechanism
Graves' disease occurs when the immune system produces antibodies that stimulate the thyroid gland to overproduce hormones. Understanding this mechanism helps explain the autoimmune nature of the condition and why treatments focus on reducing thyroid function or removing the gland entirely. Regular monitoring of thyroid function is crucial throughout treatment to adjust medication dosages and assess the disease's progression.
From the FDA Drug Label
In patients with Graves’ disease with hyperthyroidism or toxic multinodular goiter for whom surgery or radioactive iodine therapy is not an appropriate treatment option. The FDA drug label does not answer the question.
From the Research
Definition of Graves' Disease
- Graves' disease (GD) is the most common cause of hyperthyroidism worldwide 2
- It is an autoimmune disorder that leads to hyperthyroidism, characterized by an overproduction of thyroid hormones
Treatment Options
- Current therapeutic options for GD include antithyroid drugs (ATD), radioactive iodine, and thyroidectomy 2
- Antithyroid drugs, such as methimazole and propylthiouracil, are commonly used to treat GD 3, 4, 5
- Radioiodine therapy is also a treatment option, which has been compared to antithyroid medications in terms of long-term outcomes 6
Characteristics of Graves' Disease
- GD is characterized by diffuse goiter, hyperthyroidism, and often, exophthalmos (bulging of the eyes) 3
- The disease can lead to various complications, including Graves' ophthalmopathy, which can cause eye problems and vision loss 6
- The recurrence rate of GD is a major concern, with various factors influencing the risk of recurrence, including clinical characteristics, treatment strategies, and genetic and environmental factors 2