Graves Disease Symptoms

 

Graves Disease was first discovered by Irish physician, Robert Graves, during the 19th century. Graves Disease is an autoimmune disorder that involves metabolic imbalance due to the overproduction of thyroid hormones (thyrotoxicosis) from an overactive thyroid gland. It affects all age groups including children, adults especially during midlife, and elderly. It is the most common cause of hyperthyroidism in about 60-90% of cases and it involves potential hereditary factor that is around 5-10 times more common in women compared to men. It is also associated with severe hyperthyroidism that presents with more severe clinical signs and symptoms than a milder type of hyperthyroidism. Here is a brief description about the symptoms associated with Graves’ disease.

Graves’ disease Symptoms

The symptoms of Graves’ disease can either occur abruptly or slowly that are often mistaken for other health conditions. Some cases with Graves’ disease remain completely free from symptoms (asymptomatic). In general, the symptoms associated with Graves’ disease similar to that of hyperthyroidism. The thyroid gland affected with Graves’ disease, presents with hyperactive function and diffuse enlargement due to the excessive production of thyroid hormones.Graves’ disease affects various parts of the body such as the digestive system, nervous system, skin, eyes, nails, hair, bones muscles, lungs, and reproductive system.One of the most significant features of Graves’ disease includes inflammation of eye muscles (Graves’ ophthalmopathy)due to the attack of auto antibodies resulting in protrusion of one or both eyes.

Some of the classic symptoms of Graves’ disease include:

  • Thyroid gland enlargement (goiter)

  • Nervousness

  • Weight loss

  • Heat intolerance

  • Sweating

  • Diarrhea

  • Palpitations

  • Tremors

  • Exophthalmos manifested by an eyeball tissue swelling resulting in eyeball protrusion

Some of the signs and symptoms of Graves’ disease can virtually occur under the influence of hyperthyroidism, excluding the manifestations like goitre, Graves’ophthalmopathy, and pretibial myxedema due to the autoimmune mechanism of the condition.

Some symptoms are common to hyperthyroidism which include:

  • Insomnia

  • Hyperactivity

  • Hand tremor

  • Hair loss

  • Intolerance to heat

  • Excessive sweating,

  • weight loss despite healthy appetite

  • frequent defecation or diarrhea

  • palpitations

  • muscle weakness

  • warm and moist skin

Graves’ disease can also be associated with either any or all of the following symptoms:

  • Weakness

  • Shortness of breath

  • Double vision

  • Fatigue

  • Increased eye tearing

  • Muscle wasting

  • Severe hair loss

  • Pretibial myxedema manifested by a reddish-colored thickening of the skin, resulting in lumping over the shins

  • Diminished sex drive

  • Irregular or cessation of menstrual periods

  • Brittle nails

  • Abnormal enlargement of the breast in men

Thyroid storm, the most serious complication of Graves’ disease that develops suddenly due to stressful events, is associated with life-threatening liver, heart, or kidney failure.Some of the signs and symptoms manifested by thyroid storm include high blood pressure, extreme irritability, vomiting, rapid heart rate, delirium, high fever, and coma.

It proves to be fatal when left untreated.

Some of the most common signs and symptoms presented by Graves’ disease include:

  • Irritability

  • Anxiety

  • Fatigue

  • Sleeping difficulty

  • Irregular and rapid heartbeat

  • Hands and fingers present with a fine tremor

  • Warm and moist skin due to an increase in perspiration

  • Heat sensitivity

  • Weight loss, despite normal appetite

  • Changes in menstrual cycles

  • Lack of libido or erectile dysfunction

  • Frequent bowel movements or diarrhea

  • Significant thyroid gland enlargement (goiter)

  • Graves’ ophthalmopathy associated with significant bulging of the eyes

  • Graves’ dermopathy manifested by thick, red skin especially over the feet or shins

Significant features of Graves’ disease


Graves’ ophthalmopathy

Graves’ ophthalmopathy is the most common manifestation that affects half of the patients with Graves’ diseaseIt is the only type of hyperthyroidism that is manifested by discomfort, swelling, redness, irritation, inflammation and bulging of the eyes.Rarely, about less than 5 percent of cases tend to develop serious or permanent visual impairment. It can rarely affect cases with normal thyroid function and the main cause or triggering factor is unknown.It is believed to be triggered by smoking as the symptoms worsen due to smoking.The condition can rarely resolve without treatment.

Graves’ ophthalmopathy, involves inflammation and opposition of the immune system against the body itself; thus affecting various tissues and muscles around the eyes. The consequent signs and symptoms may include:

  • Bulging eyes

  • Dry, irritated eyes

  • Excess tearing

  • Puffy eyelids

  • Gritty sensation in the eyes

  • Light sensitivity

  • Pain or pressure in the eyes

  • Double vision (diplopia)

  • Inflamed or red eyes

  • Impaired or blurry vision

  • Limited eye movements, accompanied with a fixed stare

  • Corneal ulcers

Manifestations of Graves’ thyroiditis

  • Thyroid gland commonly presents with a usually symmetric, diffuse enlargement that is not tender to touch.

  • Excessive lacrimation and lid lag caused by Graves’ ophthalmopathy

  • Arrhythmias of the heart, including hypertension,atrial fibrillation, sinus tachycardia, and premature ventricular contractions.

  • Thyrotoxic cases can develop significant change in personality and behavior, such as agitation, mood swings, psychosis, and depression.

  • Cases with milder hyperthyroidism develop less severe manifestations, such as irritability,restlessness, anxiety, and emotional distress.

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