How is Graves’ disease managed or treated?
Graves’ disease is a lifelong condition. However, treatments can keep the thyroid gland in check. Medical care may even make the disease temporarily go away (remission):
- Beta-blockers: Beta-blockers, such as propranolol and metoprolol, are often the first line of treatment. These medications regulate your heart rate and protect your heart until other hyperthyroidism treatments take effect.
- Antithyroid medications: Antithyroid medications, such as methimazole (Tapazole®) and propylthiouracil, block the gland’s production of thyroid hormone. In a small percentage of people, these medications cause skin rashes and low white blood cell count, which may increase your risk of infection. Rarely, liver disease develops.
- Radiation therapy: Radioiodine therapy involves taking one dose of radioactive iodine in pill or liquid form. Over two to three months, radiation slowly destroys thyroid gland cells. (The rest of your body isn’t exposed to radiation.) As the thyroid gland shrinks, hormone levels return to normal. Women who are pregnant or breastfeeding shouldn’t get this treatment.
- Surgery: A thyroidectomy involves surgically removing all or part of the thyroid gland. After surgery, some people produce too little thyroid hormone (a condition called hypothyroidism). If you develop this problem, you may need to take thyroid replacement hormone medications, such as levothyroxine (Synthroid®) or natural desiccated thyroid (Armour® or Nature-Throid®), for life.
What are the complications of Graves’ disease?
Untreated or poorly managed Graves’ disease increases your risk for these complications:
- Eye disease: Thyroid eye disease, or Graves’ ophthalmopathy, occurs when the immune system attacks muscle and tissue around the eyes. Inflammation causes the eyes to protrude or bulge. These changes can cause double vision (seeing two of the same image) and light sensitivity. Severe swelling can damage the optic nerve and lead to vision loss.
- Heart problems: Uncontrolled Graves’ disease can cause arrhythmia (irregular heartbeat). Arrhythmia increases your risk of stroke, heart failure and other heart problems.
- Skin problems: A small number of people with Graves’ disease develop red, thickened skin on their shins and feet. This condition is called Graves’ dermopathy or pretibial myxedema. The condition isn’t painful, but it can be uncomfortable. Over-the-counter hydrocortisone creams, such as Cortizone®, can provide relief.
- Thyroid storm: Dangerously high thyroid activity speeds up body functions. It causes arrhythmia, fast pulse and shock. This life-threatening condition is known as a thyroid storm. It requires fast treatment with antithyroid medications.
How does Graves’ disease affect pregnancy?
Thyroid hormones play a key role in the development of a baby’s brain and nervous system. Untreated hyperthyroidism during pregnancy can be harmful to you and your unborn child. Your healthcare provider may test your hormone levels monthly to ensure they stay within a safe range. Too much thyroid hormone during pregnancy can increase the risk of:
- Low birth weight (newborns who weigh less than 5 pounds, 8 ounces).
- Miscarriage (loss of pregnancy before the baby is fully developed).
- Preeclampsia (high blood pressure during pregnancy).
- Premature labor (birth that occurs before the 37th week of pregnancy).
- Infant hyperthyroidism (high thyroid hormone levels in a newborn).
- Congestive heart failure in mother.