Graves' Disease Symptoms

by Elaine Moore

In GD, there may be only one predominant symptom or there may be a cluster of symptoms. No two Graves' disease patients are alike. We all run a different disease course.

The Most Common Symptoms Include Anxiety, Nervousness, Wariness, Hair and Nail Changes, Weight Loss, Increased Heart Rate and Increased Systolic Blood Pressure.

Emotional symptoms usually predominate in younger patients. Emotional symptoms include nervousness, anxiety, irritability, depression, tremors, and insomnia. In elderly patients, predominant symptoms may include apathy & depression.

Other symptoms include heat intolerance, tremors, changes in libido, increased temperature, increased sweating, frequent bowel movements, headaches, hives, nausea and vomiting, muscle weakness, fatigue, swollen lymph nodes, and increased appetite. Overall, the body's metabolism is increased.

The predominant symptoms in GD may change over time and their severity may also change. Often, these changes occur in response to stress. Stress, infections, and hormones are the most common triggers of Graves' disease. These triggers are also known to exacerbate or worsen symptoms.

Like most autoimmune disorders, Graves' disease is marked by variable periods of severity and remission. The course of GD is unpredictable. Neither thyroid hormone levels or antibody levels can predict how a particular patient will fare. Left untreated, approximately 25% to 30% of GD patients, usually those with mild symptoms, will go into spontaneous remission with each passing year. However, symptoms can progress rapidly, causing most doctors to recommend aggressive treatment.

Most of the signs and symptoms of thyrotoxicosis (excess thyroid hormone)stem from the excessive production of heat, and from increased motor activity and increased sympathetic nervous system activity.

The skin is flushed, warm, and moist; the muscles are weak and tremulous; the heart rate is rapid, the heart beat is forceful and the arterial pulses are prominent and bounding.

The increased energy expenditure causes increased appetite and, if intake is insufficient, contributes to loss of weight. There may also be insomnia, difficulty in remaining still, anxiety and apprehension, intolerance to heat, and increased frequency of bowel movements.

Angina, arrhythmias, and heart failure may be present, especially in older patients. Some GD patients may show extensive muscular wasting as a result of thyroid myopathy. Patients with long-standing undiagnosed or undertreated thyrotoxicosis my develop osteoporosis due to increased bone turnover.

In elderly patients, diagnosis is difficult, because the typical symptoms may differ. Symptoms of depression may predominate. This is called "apathetic hyperthyroidism." ♦

© 11 Mar 2006 Copyrighted by Elaine Moore