The diagnosis of Graves' disease may include:
Jul. 01, 2014
- 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.
Blood sample. Your doctor will order blood tests to determine your levels of thyroid-stimulating hormone (TSH), the pituitary hormone that normally stimulates the thyroid gland, as well as levels of thyroid hormones. People with Graves' disease usually have lower than normal levels of TSH and higher levels of thyroid hormones.
Another laboratory test measures the levels of the antibody known to cause Graves' disease. This test usually isn't necessary to make a diagnosis, but a negative result might indicate another cause for hyperthyroidism.
- Radioactive iodine uptake. Your body needs iodine to make thyroid hormones. By giving you a small amount of radioactive iodine and later measuring the amount of it in your thyroid gland with a specialized scanning camera, your doctor can determine the rate at which your thyroid gland takes up iodine. The amount of radioactive iodine taken up by the thyroid gland helps determine if Graves' disease or another condition is the cause of the hyperthyroidism. This test may be combined with a radioactive iodine scan to show a visual image of the uptake pattern.
- Ultrasound. Ultrasound uses high-frequency sound waves to produce images of structures inside the body. Ultrasound can show if the thyroid gland is enlarged, and is most useful in people who can't undergo radioactive iodine uptake, such as pregnant women.
- Imaging tests. If the diagnosis of Graves' ophthalmopathy isn't clear from a clinical assessment, your doctor may order an imaging test, such as CT scan, a specialized X-ray technology that produces thin cross-sectional images. Magnetic resonance imaging (MRI), which uses magnetic fields and radio waves to create either cross-sectional or 3-D images, may also be used.
- Bartalena L. Diagnosis and management of Graves disease: A global overview. Nature Reviews Endocrinology. 2013;9:724.
- Graves' disease. U.S. Department of Health and Human Services. http://www.endocrine.niddk.nih.gov/pubs/graves/index.aspx. Accessed March 9, 2014.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed March 9, 2014.
- Papadakis MA, ed., et al. Current Medical Diagnosis & Treatment 2014. 53rd ed. New York, N.Y.: The McGraw-Hill Companies; 2014. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=1. Accessed March 9, 2014.
- Falgarone G, et al. Role of emotional stress in the pathophysiology of Graves' disease. European Journal of Endocrinology. 2013;168:R13.
- Ross DS. Treatment of Graves' hyperthyroidism. http://www.uptodate.com/home. Accessed March 9, 2014.
- Genovese BM, et al. What is the best definitive treatment for Graves' disease? A systematic review of the existing literature. Annals of Surgical Oncology. 2013;20:660.
- Mayo CH. The surgical treatment of goiter. The Journal of the American Medical Association. 1904;XLII:1059.
- Riggin EA. Decision Support System. Mayo Clinic, Rochester, Minn. March 3, 2014.
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