Graves' disease, also known as toxic diffuse goiter is an autoimmune disease that affects

the thyroid. It frequently results in hyperthyroidism and an enlarged thyroid. About 25% to
80% of people develop eye problems.[1][2]
The exact cause is unclear; however, it is believed to involve a combination of genetic and
environmental factors.[3] A person is more likely to be affected if they have a family member
with the disease.[1] If one twin is affected there is a 30% chance the other twin will also have
the disease.[4] The onset of disease may be triggered by stress, infection, or giving birth.
[2]
Those with other autoimmune diseases such as type 1 diabetes and rheumatoid arthritis are
more likely to be affected.[1] Smoking increases the risk of disease and may make the eye
problems worse.[1] The disorder results from an antibody, called thyroid stimulating
immunoglobulin (TSI), that has a similar effect to thyroid stimulating hormone (TSH). These
antibodies cause the thyroid gland to produce excess thyroid hormone.[1]The diagnosis may be
suspected based on symptoms with blood tests and radioiodine uptake used to confirm the
disease.[1][2]Typically blood tests show a raised T3 and T4, low TSH, increased radioiodine
uptake in all areas of the thyroid, and TSI antibodies.[2]
Graves disease carrier protein (GDC) is a protein of as yet uncharacterised function that belongs to the mitochondrial
metabolite carrier . The protein is recognised by IgG from patients with active Graves disease

There are three treatment options: radioiodine therapy, medications, and thyroid surgery.
Radioiodine therapy involves taking iodine-131 by mouth which is then concentrated in and
destroys the thyroid over weeks to months. The resulting hypothyroidism is treated
with synthetic thyroid hormone. Medications such as beta blockers may control the symptoms
and anti-thyroid medications such asmethimazole may temporarily help people while other
treatments are having effect. Surgery to remove the thyroid is another option. Eye problems
may require additional treatments.[1]
Graves' disease occurs in about 0.5% of people.[2] It occurs about 7.5 times more often in
women than men.[1] Often it starts between the ages of forty and sixty.[4] It is the most
common cause of hyperthyroidism in the United States

Symptoms
Common signs and symptoms of Graves' disease include:

Anxiety , irritability , mood changes

A fine tremor of your hands or fingers
Heat sensitivity and an increase in perspiration or warm, moist skin
Weight loss, despite normal eating habits
Enlargement of your thyroid gland (goiter)
Change in menstrual period
Erectile dysfunction or reduced libido

Frequent bowel movements

Bulging eyes (Graves' ophthalmopathy)
Thick, red skin usually on the shins or tops of the feet (Graves' dermopathy)
Rapid or irregular heartbeat (palpitations)
muscle bulk
Graves' ophthalmopathy
About 30 percent of people with Graves' disease show some signs and symptoms of a
condition known as Graves' ophthalmopathy
Bulging eyes (exophthalmos)

Pressure or pain in the eyes

Puffy, drooping or retracted eyelids
Reddened or inflamed eyes
Light sensitivity
Double vision
Vision loss
Graves' dermopathy
An uncommon manifestation of Graves' disease, called Graves' dermopathy, is the reddening
and thickening of the skin, most often on your shins or the tops of your feet.
When to see a doctor
A number of medical conditions can cause the signs and symptoms associated with Graves'
disease. See your doctor if you experience any potential Graves-related problems to get a
prompt and accurate diagnosis.
Seek emergency care if you're experiencing heart-related signs and symptoms, such as a rapid
or irregular heartbeat, or if you develop vision loss.
The main antithyroid drugs are carbimazole methimazole , and propylthiouracil/PTU. These
drugs block the binding of iodine and coupling of iodotyrosines. Patients on these
medications should see a doctor if they develop sore throat or pyrexia. The most common side
effects are rash and peripheral neuritis.
For some patients, finding the correct thyroid replacement hormone and the correct dosage
may take many years and may be in itself a much more difficult task than is commonly
understood.
An alternative natural treatment for the eye condition is to rub a cold black tea bag around the
eyes a few times a day. The patients who tried it, showed improvment in less than 2 weeks.