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Symptoms
By Mayo Clinic staff
Graves' disease symptoms may include:
- Anxiety
- Irritability
- Difficulty sleeping
- Fatigue
- A rapid or irregular heartbeat
- A fine tremor of your hands or fingers
- An increase in perspiration
- Sensitivity to heat
- Weight loss, despite normal food intake
- Brittle hair
- Enlargement of your thyroid gland (goiter)
- Change in menstrual cycles
- Frequent bowel movements
Graves' ophthalmopathy
It's also fairly common for your eyes to exhibit mild signs of a condition known as Graves' ophthalmopathy. In Graves' ophthalmopathy, your eyeballs bulge out past their protective orbit (exophthalmos). This occurs as tissues and muscles behind your eyes swell and cause your eyeballs to move forward. Because your eyes may be pushed so far forward, the front surface of your eyes can become dry. Cigarette smokers with Graves' disease are five times more likely than nonsmokers to develop Graves' ophthalmopathy. This is possibly because smoking inhibits the absorption of anti-thyroid medication that is used to treat Graves' disease.
Graves' ophthalmopathy may cause these mild signs and symptoms:
- Excess tearing and sensation of grit or sand in either or both eyes
- Reddened or inflamed eyes
- Widening of the space between your eyelids
- Swelling of the lids and tissues around the eyes
- Light sensitivity
Less often, Graves' ophthalmopathy can produce these serious signs and symptoms:
- Ulcers on the cornea
- Double vision
- Limited eye movements
- Blurred or reduced vision
Graves' dermopathy
An uncommon sign of Graves' disease is reddening and swelling of the skin, often on your shins and on the top of your feet, called Graves' dermopathy.
When to see a doctor
See your doctor if you have signs and symptoms suggesting Graves' disease, particularly:
- An enlarged thyroid
- Protruding eyes
- Anxiety
- Intolerance to heat
- Tremor
- Weight loss
Seek emergency care if you are experiencing heart-related signs and symptoms, such as a rapid or irregular heartbeat.
- Graves' disease. U.S. Department of Health and Human Services. http://www.endocrine.niddk.nih.gov/pubs/graves/Graves.pdf. Accessed April 23, 2009.
- Hyperthyroidism. American Association of Clinical Endocrinologists. http://www.aace.com/pub/thyroidbrochures/pdfs/Hyperthyroidism.pdf. Accessed April 23, 2009.
- Nyirenda MJ, et al. Thyroid-stimulating hormone-receptor antibody and thyroid hormone concentrations in smokers vs. nonsmokers with Graves' disease treated with carbimazole. Journal of the American Medical Association. 2009;301:162.
- Cawood TJ, et al. Smoking and thyroid-associated ophthalmopathy: A novel explanation of the biological link. The Journal of Clinical Endocrinology and Metabolism. 2007;92:59.
- Davies TF. Pathogenesis of Graves' disease. http://www.uptodate.com/home/index.html. Accessed April 27, 2009.
- Brent GA. Graves' disease. New England Journal of Medicine. 2008;358:2594.
- Rubin DI. Neurologic manifestations of hyperthyroidism and Graves' disease. http://www.uptodate.com/home/index.html. Accessed April 27, 2009.
- Davies TF. Treatment of Graves' ophthalmopathy (orbitopathy). http://www.uptodate.com/home/index.html. Accessed April 27, 2009.
- Nippoldt TB (expert opinion). Mayo Clinic, Rochester, Minn. May 13, 2009.
- Propylthiouracil-induced liver failure. U.S. Food and Drug Administration. Accessed June 17, 2009.
