Graves Disease

Mohita A. Patel, MD and Nora Gimpel, MD Reviewed 05/2014



Autoimmune disease in which thyroid-stimulating antibodies cause increased thyroid function; most common cause of hyperthyroidism. Classic findings are goiter, ophthalmopathy (orbito...


Hyperthyroid patients appear hypermetabolic with increased adrenergic tone.


  • Tachycardia, palpitations

  • Tremor, restlessness

  • Hyperactivity, anxiety, emotional lability, insomnia

  • Sweating, h...



Goal is to correct hypermetabolic state with the fewest side effects and lowest incidence of posttreatment hypothyroidism.

First Line

  • Radioactive iodine (RAI):

    • Concentrates in the thy...

Ongoing Care

Follow-Up Recommendations

Patient Monitoring

  • Monitoring is for resolution of hyperthyroidism and for development of hypothyroidism.

  • Check TSH and T4 levels every 1–2 months for first 6 month...


Helfand M. U.S. Preventive Services Task Force. Screening for subclinical thyroid dysfunction in nonpregnant adults: A summary of the evidence for the U.S. Preventive Services Task Force. ...

Additional Reading

See Also

See also topics: Anxiety; Cardiac Arrhythmias; Weight Loss



  • 242.00 Toxic diffuse goiter without mention of thyrotoxic crisis or storm

  • 242.01 Toxic diffuse goiter with mention of thyrotoxic crisis or storm

  • 242.0 Toxic diffuse goiter


  • E05.0 Thyrotoxic...

Clinical Pearls

Thyroid hormone controls metabolic rate and affects many organ systems. Hyperthyroid patients appear hypermetabolic, with symptoms and signs of increased adrenergic tone.

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