Graves’ Disease: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate Graves’ disease:

I. Symptoms of hyperthyroidism (overactive thyroid)

Leading symptomsbasic metabolic rate

Increase in body temperature → heat intolerance or hypersensitivity to heat (thermophobia).
Sweating
Warm moist skin
Weight loss (despite increased appetite)

Cardial (cardiovascular)

Tachycardia – heartbeat too fast: > 100 beats per minute [cardiac output volume (HMV) ↑]
Systolic blood pressure elevated (blood pressure amplitude ↑).
Palpitations (heart palpitations)

Gastrointestinal (gastrointestinal tract)

Nervous system and psyche

Associated symptoms

Alopecia (hair loss, diffuse)
Weight gain – in 5-10% of affected individuals due to increased appetite.
Gynecomastia – enlargement of the mammary gland in men.
Hyperreflexia
Muscle weakness, proximal
Fatigue, weakness
Lack of concentration
Loss of libido – decreasing sex drive
Oligomenorrhea – the interval between bleeding is > 35 days and < 90 days, i.e. the period occurs too infrequently
Palmar erythema – red coloration of the palms.
Polyuria – frequent urination (due to increased organ blood flow: GFR ↑).
Pruritus (itching)
Serum cholesterol ↓

Goiter (thyroid enlargement; hypervascularized) – see under goiter, if applicable.

Exophthalmos (synonyms: endocrine ophthalmopathy; ophthalmoptosis; ophthalmopathy; protrusio bulbi; popularly known as “googly eyes”) – pathologic protrusion of the eyeball from the orbit [occurrence: before, during, or after the onset of hyperthyroidism].
Redness of the conjunctiva (conjunctiva).
Incomplete closure of the eyelids (lagophthalmos).
Foreign body sensation in the eyes and increased lacrimation
When lowering the gaze, the upper eyelid remains behind, so that in exophthalmos the part of the sclera visible above the cornea is enlarged (Graefe’s sign)
Corneal lesions (corneal injuries).
If necessary, eye muscle involvement and eye muscle paresis with double vision.
When the optic nerve is compressed, there is a decrease in visual acuity (visual acuity) and limitation of color vision

Dermopathy – skin changes similar to orange peel skin, mostly on the lower legs.
Pretibial (anterior to the shin) myxedema – skin (including subcutaneous and adipose tissue) is typically doughy swollen, cool, dry, and rough (especially on the extremities and face); patients look puffy.
Acropachy – Bone thickening (due to subperiosteal bone apposition) with concomitant soft tissue thickening (painless; normal temperature) on the finger and toe end links (I-III) and onycholysis (nail plate detachment).

The so-called Merseburg triad of Graves’ disease is composed of the following symptoms: