Graves' Disease

Treatment

Mayo Clinic offers comprehensive treatment for Graves' disease. An endocrinologist will usually supervise the care of the patient, and an eye specialist will be involved if the patient requires treatment for Graves' ophthalmopathy. After receiving treatment, patients are re-evaluated periodically to ensure that the treatment plan is working properly.

Treatment for Thyroid Symptoms

Medications. Two types of medications may be prescribed to Graves' disease patients. The first is called beta-blockers. They do not cure Graves' disease, but rather block some of the actions of the thyroid, and are used in conjunction with other treatments. Second, antithyroid medications, which are used only in a small percentage of patients, prevent the thyroid from producing excessive hormones. Some patients experience long-term remission with antithyroid medications, but relapse is common.

Radioactive Iodine Treatment. In this most common treatment for Graves' disease, a patient drinks a solution containing radioactive iodine. The iodine collects in the thyroid, and over time the overactive thyroid cells are destroyed, the thyroid gland shrinks and symptoms gradually subside, usually within three months. Most patients need hormone treatment following radioactive iodine treatment to ensure their bodies have normal amounts of thyroid hormones. Mayo doctors provide close follow-up care to adjust thyroid hormone levels and try to prevent a relapse.

Surgery. In rare cases, patients who can't tolerate medications or don't have radioactive iodine treatment may have the thyroid gland surgically removed. Hormone therapy is necessary following surgery to maintain normal levels of thyroid hormones.

Treatment for Eye Symptoms (Graves' Ophthalmopathy)

When Graves' disease affects the eyes (Graves' ophthalmopathy), a physician may recommend several self-care options if the symptoms are mild:

• Applying cool compresses to the eyes
• Using lubricating eyedrops
• Wearing sunglasses
• Elevating the head of the bed

For more severe symptoms, Mayo Clinic has a specialized ophthalmology team with a long history of treating and researching Graves' ophthalmopathy. They may recommend one or more of the following treatments, depending on the severity of eye symptoms:

Medications. Medications (corticosteroids called prednisone) reduce the inflammation behind the eye, relieving discomfort.

Orbital decompression surgery. The surgeon removes a portion of bone between the eye socket and sinuses, allowing more room for the swollen tissues behind the eyes. This decreases the pressure behind the eyes, relieves discomfort and allows the eyes to assume a more normal position.

Eye muscle surgery. Swelling of the eye muscles associated with Graves' ophthalmopathy can cause eye muscles to become "stiff" or "tight," causing misalignment of the eyes and double vision. In eye muscle surgery, the surgeon detaches the muscle from the eye, and reattaches it farther back to correct the misalignment. The goal of eye muscle surgery is to achieve single vision while looking straight ahead and while reading.

Eyelid surgery. Because of protruding eyes and/or retracted eyelids, patients with Graves' ophthalmopathy experience discomfort because their eyelids open more widely, and they may have difficulty closing their eyelids completely. Surgical repositioning of the eyelid can reduce irritation and discomfort.

Prisms. Double vision associated with Graves' ophthalmopathy, or as a temporary condition associated with eye surgery, may be corrected by prescription prisms in glasses.

Treatment for Skin Symptoms (Graves' Dermopathy)

The red, swollen skin of a patient with Graves' dermopathy is often treated with prescription creams and ointments and leg wrappings.