The course and severity of the disease can vary greatly. In the foreground are the symptoms resulting from thyroid enlargement and hyperfunction. These include, in particular:
- Rapid, sometimes irregular pulse
- Trembling of the hands
- Sensitivity to heat
- Tendency to sweat
- Nervousness
- Weight loss
Change of the eyes in Graves’ disease
In about half of the patients of Graves’ disease, visual disturbances and eye changes are added. These are characterized by a “gawking look” with bulging eyes (exophthalmos), red, burning, squeezing eyes, and sometimes impairment of muscle and visual function.
The swelling may be so pronounced that eyelid closure is no longer possible. These eye symptoms are also known as “endocrine opthalmopathy.”
Merseburg triad secondary to Graves’ disease.
Less common are symptoms due to immune disorders, which in principle can affect all organs and are not always clearly assignable. The Merseburg triad is the classic combination of three main symptoms:
- Thyroid enlargement
- Exophthalmos
- Rapid pulse
Diagnostics of Graves’ disease
Often, medical history and symptoms are already so typical that, in addition to the physical examination, only blood tests need to be performed. Thyroid hormones and various antibodies against the thyroid tissue (TRAK, TPO-AK) are determined in particular.
Ultrasound can be used to visualize the tissue and the blood flow. This may be followed by scintigraphy to assess the metabolic activity and function of the thyroid gland.
Therapy of Graves’ disease
In some cases, recovery occurs without treatment; however, the disease can always recur. If the hyperfunction persists, therapy is inevitable – otherwise there is a risk of developing a life-threatening “thyrotoxic crisis.” Treatment is based on suppression of the hyperfunction.
In addition to medication, therapeutic options include radioiodine treatment, in which the thyroid tissue is irradiated radioactively and thus destroyed, and partial or complete surgical removal of the thyroid gland. Sometimes therapy produces hypothyroidism, which in turn must be controlled with medication.
