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Hyperthyroidism
How does Graves' Disease affect the eyes?
Graves' disease is associated with inflammation of the eyes, swelling of the tissues around the eyes, and bulging of the eyes. However, 99% of the time, this inflammation will not cause serious or permanent trouble. Early signs of Graves' Disease affecting the eyes include:
  • Bulging of the eyes due to inflammation of the tissues behind the eyeball (the medical term is exophthalmos)
  • Blurred or diminished vision
  • Red or inflamed eyes
  • Double vision

    It is believed that the swelling is caused by antibodies attacking the tissues of the eye muscles. There may also be a sensitivity to light, and a continual feeling that there is something in the eyes. Such symptoms usually appear within six months of when the diagnosis of Graves' Disease is made.

    How does Graves' Disease affect the skin?
    Although it is rare, Graves' Disease patients will sometimes get a lumpy reddish thickening of the skin in front of the shins (pretibial skin). This condition is known as "pretibial myxedema". It's usually painless, not serious and, may not start even when the hyperthyroidism starts. As with the eyes, it is believed that this swelling in the pretibial skin is caused by antibodies attacking these tissues.

    What else do I need to know about Graves' Disease?
  • If hyperthyroidism eye complications occur, see an eye doctor in addition to your regular physician.
  • Smoking tends to worsen the eye problems associated with Graves' disease--yet another reason to quit.
  • It is more prevalent in women than in men, by a ratio of about 8 to 1.
  • Typically occurs in middle age

    How can a doctor diagnose one of the variations of hyperthyroidism?
  • Initial diagnosis usually simply requires a physical examination for the following:
  • Enlarged thyroid gland
  • Rapid heart rate or heart palpitations
  • Smooth, velvety skin
  • Tremor of the fingertips

    Other symptoms are:
  • Fatigue
  • Sweaty palms
  • Weight loss
  • Fine brittle hair
  • Restlessness
  • Depression
  • Increased appetite
  • Changes in sex drive
  • Muscle weakness, especially in the upper arms and thighs
  • Shortened attention span
  • Heat intolerance
  • Increased sweating
  • Nervousness and irritability
  • Restless sleep or insomnia
  • Erratic behavior
  • For women, irregular menstrual cycle and reduced menstrual flow,
  • Infertility, recurrent miscarriage
  • Increased frequency of bowel movements

    A family medical history may also hold clues to a diagnosis of hyperthyroidism, especially if a close family member:
  • Had either an overactive or an underactive thyroid
  • Had hair that went gray starting in their 20's
  • Had problems with their immune system, such as juvenile diabetes

    A final diagnosis is always made by means of a blood test which will demonstrate abnormally high thyroid hormone levels and low levels of the thyroid-stimulating hormone (TSH) produced by the pituitary gland. Low blood TSH levels are the most reliable test of most hyperthyroidism. In rare cases, the pituitary gland produces excess amounts of TSH. Then there will be increased levels of both the TSH and thyroid hormones in the blood.

    Sometimes, thyroid-stimulating antibodies (TSAb) or Thyroid Stimulating Immunoglobulin (TSI) in the blood will also be measured.

    Finally, a radioactive picture of the thyroid, made by ingesting radioactive iodine (known as RAI), may also be taken to see if the thyroid gland is overactive. A diffuse overactivity of the thyroid gland is a hallmark of Graves' disease, but not of overactive nodules or lumps within the gland.



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