Graves' Disease

Your healthcare provider will ask about your symptoms and medical history, including your family history of thyroid disease, and perform a physical exam. They may also order the following tests to confirm a Graves’ disease diagnosis:

Thyroid blood tests: These blood tests check the level of thyroid hormone in your blood and amounts of thyroid-stimulating hormone (TSH). A low TSH level indicates that your thyroid gland is producing too much hormone. The overproduction causes your pituitary gland to make less TSH.

Thyroid antibody blood tests: These tests help identify different types of autoimmune thyroid conditions. The two types of antibodies linked with Graves’ disease include TSI (thyroid-stimulating antibodies) and TBII (thyrotropin binding inhibitory immunoglobulins).

Thyroid uptake and scan: In this test, you take a small amount of radioactive iodine orally. Your provider will check to see how much of the radioactive iodine your thyroid absorbs. High levels of iodine absorption can be a sign of Graves’ disease.

Doppler blood flow measurement (Doppler ultrasound): This test uses sound waves to detect increased blood flow in your thyroid due to Graves’ disease. Your provider may order this test if radioactive iodine uptake is not a good option for you, such as during pregnancy or breastfeeding.

Graves’ disease is a lifelong (chronic) condition. However, treatments can keep your thyroid hormone levels in check. Medical care may even make the disease temporarily go away (remission).

Treatments for Graves’ disease include:

Beta-blockers: Beta-blockers, such as propranolol and metoprolol, are often the first line of treatment for Graves’ disease. These medications regulate your heart rate and protect your heart until other hyperthyroidism treatments take effect. These medications don’t stop thyroid hormone production.

Antithyroid medications: Antithyroid medications, such as methimazole (Tapazole®) and propylthiouracil, block your thyroid’s production of thyroid hormone. In a small percentage of people, these medications cause skin rashes and low white blood cell count, which may increase your risk of infection. Rarely, liver disease develops.

Radioiodine therapy: This therapy involves taking one dose of radioactive iodine in pill or liquid form. Over two to three months, radiation slowly destroys thyroid gland cells. (The rest of your body isn’t exposed to radiation.) As your thyroid gland shrinks, hormone levels return to normal. People who are pregnant or breastfeeding shouldn’t get this treatment. If you have this treatment, you’ll likely eventually develop hypothyroidism (underactive thyroid), which requires medication. But hypothyroidism is easier to treat than hyperthyroidism and it causes fewer long-term health problems.

Surgery: A thyroidectomy involves surgically removing all or part of your thyroid gland. After surgery, some people produce too little thyroid hormone (hypothyroidism). If you develop this condition, you may need to take thyroid replacement hormone medications, such as levothyroxine (Synthroid®), for the rest of your life.