Graves' Disease

Diagnosis

CT scan of the eyes of a patient with Graves' ophthalmopathy

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Graves' disease is generally diagnosed following a physical exam, and confirmed with laboratory tests. Other factors that may be associated with Graves' disease include a family history of thyroid problems, premature gray hair, painless white patches on the skin (vitiligo) — or other autoimmune problems such as juvenile diabetes or pernicious anemia.

Physical exam. Doctors assess a patient's symptoms and family history. They examine the thyroid gland, looking for enlargement — and the eyes to see if they're irritated or protruding. Because Graves' disease often increases the metabolism, exams include testing a patient's pulse and blood pressure.

Blood tests. Doctors use blood tests to determine if the thyroid functions normally, measuring levels of thyroid stimulating hormone (TSH), thyroixine (T4) and triiodothyronine (T4). In some cases they use a blood test to measure thyroid antibodies, including thyroid stimulating immunoglobulin (TSI).

Radioactive iodine uptake. This non-blood test measures the rate at which the thyroid absorbs iodine. If too much is absorbed, the body is producing too much thyroxine, which indicates Graves' disease.

Imaging tests. If a Graves' disease patient has eye problems, he or she may undergo an orbit CT scan, a procedure that uses computer tomography to examine the eyes and eye sockets. A contrast dye may be injected before the test. Magnetic resonance imaging (MRI) also may be performed to get additional images of the eyes.