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Graves Disease

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Signs and Symptoms

Graves disease may cause a wide range of signs and symptoms. They usually develop slowly, often beginning as mild and going unnoticed at first, and then progressively worsen. Different people may experience a different combination of symptoms at various times.

Graves disease can cause a condition known as exophthalmos or Graves ophthalmopathy. With this condition, tissue can build up behind the eyeballs and the eyelids can retract, leading to a characteristic fixed stare and protruding eyes. This can dry and irritate the eyes, interfere with vision, and in severe cases can cause damage to the cornea, the transparent covering at the front of the eye, and to the optic nerve, the nerve that transmits light images to the brain, resulting in vision loss. This symptom affects about 30% of the people diagnosed with Graves disease.

Some other signs and symptoms may include:

  • Difficulty concentrating
  • Double vision
  • Eye irritation and tearing
  • Fatigue
  • Frequent bowel movements
  • Enlarged thyroid gland (goiter)
  • Breast enlargement (gynecomastia) in men (rare)
  • Hand tremors
  • Heat sensitivity
  • Impotence or reduced libido
  • Increased appetite
  • Increased or irregular heartbeat (palpitations or arrhythmia)
  • Insomnia
  • Loss of endurance
  • Menstrual irregularities
  • Muscle weakness
  • Nervousness
  • Protruding eyes (exophthalmos) and/or fixed stare
  • Reddening and thickening of skin on shins
  • Restlessness and nervousness
  • Sweating
  • Unexplained weight loss

Graves disease during pregnancy can cause transient hyperthyroidism in the newborn because thyroid stimulating antibodies can be transferred to the fetus. In children, Graves disease can affect height, rate of development, and puberty.

Long-term exposure to excess thyroid hormones can cause osteoporosis. Sudden acute increases in thyroid hormones can cause a "thyroid storm" or thyrotoxic crisis that can be life-threatening.

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