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Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
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Tests and diagnosis
By Mayo Clinic staffTo diagnose Graves' disease, your doctor typically uses these procedures:
- Physical exam. Your doctor examines your eyes to see if they're irritated or protruding and looks to see if your thyroid gland is enlarged. Because Graves' disease increases your metabolism, your doctor will check your pulse and blood pressure and look for signs of tremor. Your doctor will also ask you about your symptoms and your personal and family medical histories.
- Blood sample. Your doctor will likely order blood tests to determine your levels of thyroid-stimulating hormone (TSH) and thyroxine. TSH, produced by your pituitary gland, is the hormone that normally stimulates the thyroid gland. In Graves' disease, an abnormal antibody called TRAb mimics TSH, causing elevated thyroxine even while TSH levels remain low. If you have very low levels of TSH and high levels of thyroxine, your doctor may diagnose Graves' disease.
- Radioactive iodine uptake. Your body needs iodine to make thyroxine. By giving you a small amount of radioactive iodine and later measuring the amount of it in your thyroid gland, your doctor can determine the rate at which your thyroid gland takes up iodine. A high uptake of radioactive iodine indicates your thyroid gland is producing too much thyroxine, as is the case in Graves' disease. Low uptake occurs in some of the other causes of hyperthyroidism.
References
- 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.
