What Are The Signs of Graves’ Disease?

Graves’ disease is an autoimmune disorder that causes hyperthyroidism. Knowing the signs and symptoms of this disease will enable you to detect it earlier rather than later. 

Have you considered clinical trials for Graves' disease?

We make it easy for you to participate in a clinical trial for Graves' disease, and get access to the latest treatments not yet widely available - and be a part of finding a cure.

Graves’ disease

Grave’s disease is an autoimmune disorder that affects thyroid function. As a result of this condition, the thyroid becomes overactive. An overactive thyroid is called hyperthyroidism.

The thyroid is a butterfly-shaped organ located in the front of your neck and its main purpose is to release hormones into the body. 

The thyroid produces and secretes three hormones. These hormones are:

  • Triiodothyronine, also called T3

  • Tetraiodothyronine, also called thyroxine or T4

  • Calcitonin

Calcitonin is involved in bone metabolism. However, the hormones T3 and T4 can act on almost every cell within your body.  

The effects¹ that T3 and T4 have on your body are:

  • Regulating metabolism

  • Growth and brain development 

  • Regulating body temperature

  • Regulating heartbeat 

  • Activation of the nervous system

When the immune system becomes dysfunctional and attacks the thyroid, it can disrupt several bodily processes. As with Graves’ disease, immune antibodies latch onto cells in the thyroid, causing them to malfunction and release more thyroid hormones into your body. 

As a result of these extra hormones, many processes in your body work much faster. If Graves’ disease or hyperthyroidism is left untreated, there can be severe consequences.

What causes Graves’ disease?

Graves’ disease is an autoimmune disorder caused by dysfunctional immune cells. The immune cells mistakenly perceive the thyroid as a threat to the body and start producing antibodies to act against the thyroid. 

Although there is an autoimmune component to this disease, scientists² still have no clear picture of why the immune system starts targeting the thyroid. 

Graves’ disease and hyperthyroidism

You may have heard the term hypothyroidism, and it sounds very similar to hyperthyroidism. Because of this, it can be easy to get these two terms mixed up. 

Hypothyroidism is when the thyroid is underactive and secretes fewer hormones. In contrast, hyperthyroidism is when the thyroid is overactive and secretes more hormones. 

Some people remember ‘hypo is slow’ to distinguish these terms more easily. Slow refers to the slower metabolic rate that occurs due to an underactive thyroid. 

If you have Graves’ disease, your thyroid will initially be overactive rather than underactive. The symptoms of an underactive thyroid can differ from those for an overactive thyroid. 

Signs and symptoms of Graves’ disease and hyperthyroidism 

Because Graves’ disease causes the thyroid to become overactive, many symptoms crossover with hyperthyroidism. Other causes of hyperthyroidism include thyroid nodules, or inflammation of the thyroid gland post pregnancy or infection.

While Graves' disease has several signs and symptoms, you are unlikely to encounter all of them because the condition can affect people differently. 

Here you will find the details of many symptoms associated with Graves’ disease. 

Weight loss and increased appetite

With hyperthyroidism, energy from food is used up quickly, and stored energy in your body is rapidly depleted. Because food is used up faster, your appetite¹ will increase to keep up with this demand. 

But while your appetite is increased, you can still lose a significant amount of weight because stored energy is also being utilized. 

When the thyroid hormones T3 and T4 are elevated, they can act on many cells within your body and increase the speed of cell functions. As a result, the metabolic rate of those cells will have increased, and they will demand more energy. 

Therefore, your body will use every bit of energy it can find to keep up with your quickened metabolism. 

Irregular or rapid heart rate

Many factors within the body control heart rate, and the hormones T3 and T4 are one of them.

When T3 and T4 are elevated, they can increase the heart rate. In contrast, the heart rate can slow down when these hormones are only present in low quantities. 

With Graves’ disease, since the thyroid produces more T3 and T4 than usual, the heart rate will increase or become irregular. As a result, you may notice that your heart is beating faster or you might feel a fluttering sensation in your chest. 

Changes in mood

With more T3 and T4 circulating around your body, you may notice mood changes because the higher levels of these hormones can act on your nervous system, making you feel nervous and jittery. 

Difficulty sleeping and daytime tiredness

With the larger amount of thyroid hormones circulating around your body, you might have difficulty falling asleep or staying asleep. 

The reason why this occurs is that hyperthyroidism can disrupt your circadian rhythm.³ The circadian rhythm regulates the sleep-wake cycle and repeats every 24 hours. 

When your circadian rhythm is disrupted, you will find it difficult to fall asleep, which could lead you to feeling tired during the day. 

Muscle weakness

Thyrotoxic myopathy⁴ is a complication of Graves’ disease and causes muscle problems. 

The main symptoms related to this disorder are:

  • Muscle weakness

  • Muscle tenderness

  • Muscle fatigue

  • Wasting of the muscles around the pelvis and shoulders

  • Tremors and shaky hands

  • Heat intolerance

If thyrotoxic myopathy is left untreated, it can worsen because the muscles will become very weak as they break down.

Irregular or frequent bowel motions

Hyperthyroidism can cause diarrhea or frequent bowel motions. Due to the increased amount of thyroid hormones, bodily processes speed up. 

The operation of the digestive tract also speeds up, and food passes through it more quickly. As a result, this increases the number of bowel motions per day. 

Goiter

A goiter is an enlarged thyroid gland that causes the front of the neck to look swollen or puffy. If left untreated, there are a few complications. 

When the thyroid gland swells in the front of the neck, it will also swell inwards. As it protrudes in, it may push against your airways and the esophagus. 

As a result, you might find it difficult to breathe or swallow food. If the swelling increases and remains untreated, this would cause further complications with eating and breathing. 

Eye problems

Ophthalmopathy is another secondary condition of Graves’ disease that affects the eyes.

Common symptoms of ophthalmopathy include:

  • Bulging eyes

  • Irritated eyes

  • The sensation of a painful pressure in the eyes

  • Sore or red eyes

  • Sensitivity to bright light

  • Puffiness around the eyes

  • Blurred vision 

  • Double vision

  • Vision loss, if left untreated 

Ophthalmopathy often occurs earlier rather than later during the course of the disease, and can happen when the other Graves’ disease symptoms start to appear. 

Mild ophthalmopathy is relatively common and affects one in three people with Graves’ disease.

Skin problems

Another complication of Graves’ disease is dermopathy, which is a skin condition that causes lesions. However, compared to other complications of Graves’ disease, this one is rarer than others. 

Common symptoms of dermopathy include:

  • Reddish areas of the skin

  • Thickening of the skin

  • A rough texture to the skin

Areas of the body that are typically affected are the shins and feet. However, it can occur in other areas as well. 

Menstrual changes

The effects that Graves’ disease and hyperthyroidism have on the menstrual cycle⁵ can be hard to predict because they can affect people differently. 

Graves’ disease can increase or decrease menstrual flow. Experts say⁵ that decreased menstrual flow occurs more commonly than increased flow. 

Should you experience a decrease in menstruation, it can eventually lead to the absence of menstruation or missed periods. 

As a result of the menstrual disruptions, this can also cause a reduction in fertility, which resolves once treated

Who has a high risk of developing Graves’ disease?

Certain individuals are more susceptible to developing Graves' disease. Here are some potential factors² you might want to consider. 

Graves' disease is more common in women than men and more likely to affect those over the age of 30.

People who have a family history of thyroid disorders are also at greater risk. However, regardless of what thyroid disorders are present in your family, it does not mean you will develop the same condition. For example, you may have a blood relative with Hashimoto's disease (an underactive thyroid), and you might develop Graves' disease instead. Both are autoimmune conditions. 

People with pre-existing autoimmune disorders like rheumatoid arthritis or autoimmune gastritis are more likely to develop Graves' disease. 

Additionally, people with type 1 diabetes are also at risk. 

When to see a doctor

If you experience any of the mentioned symptoms and signs or have a family history of thyroid disorders, you should inform your doctor. 

Your doctor will be able to order some blood tests, which will confirm if you have a thyroid disorder. The tests might also indicate which type of disorder is present. However, further testing will be required. 

If your symptoms are severe or you have difficulty breathing, you should seek help immediately. 

The lowdown

There are many signs and symptoms of Graves’ disease and hyperthyroidism. Addressing each potential symptom is important because the complications of this disease can become very severe if left untreated. 

If you have Graves’ disease, your doctor can get you started on a treatment to alleviate your symptoms.

  1. How does the thyroid gland work? (2010)

  2. Graves’ disease | National Institute of Diabetes and Digestive and Kidney Diseases

  3. The hypothalamic–pituitary–thyroid axis and sleep (2021)

  4. Thyrotoxic myopathy information page | National Institute of Diabetes and Digestive and Kidney Diseases

  5. Disturbances of menstruation in thyroid disease | The New York Academy of Sciences

Have you considered clinical trials for Graves' disease?

We make it easy for you to participate in a clinical trial for Graves' disease, and get access to the latest treatments not yet widely available - and be a part of finding a cure.

Joining community groups and exercise programs for my condition made me feel empowered – but I want to be part of finding a cure.
Peter, 64


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