2018 European Thyroid Association Guideline for the Management of Graves' Hyperthyroidism. In: Current Medical Diagnosis & Treatment 2020. In: Harrison's Principles of Internal Medicine. National Institute of Diabetes and Digestive and Kidney Diseases. Too much thyroid hormone interferes with your body's ability to incorporate calcium into your bones.
The strength of your bones depends, in part, on the amount of calcium and other minerals they contain. Untreated hyperthyroidism also can lead to weak, brittle bones (osteoporosis). Thyroid storm requires immediate emergency care.
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The sudden and drastic increase in thyroid hormones can produce many effects, including fever, sweating, vomiting, diarrhea, delirium, severe weakness, seizures, irregular heartbeat, yellow skin and eyes (jaundice), severe low blood pressure, and coma. It's more likely when severe hyperthyroidism is untreated or treated inadequately. A rare but life-threatening complication of Graves' disease is thyroid storm, also known as accelerated hyperthyroidism or thyrotoxic crisis. If left untreated, Graves' disease can lead to heart rhythm disorders, changes in the structure and function of the heart muscles, and the inability of the heart to pump enough blood to the body (heart failure). Preeclampsia is a maternal condition that results in high blood pressure and other serious signs and symptoms. Possible complications of Graves' disease during pregnancy include miscarriage, preterm birth, fetal thyroid dysfunction, poor fetal growth, maternal heart failure and preeclampsia. Smokers who have Graves' disease are also at increased risk of developing Graves' ophthalmopathy.Ĭomplications of Graves' disease can include: Cigarette smoking, which can affect the immune system, increases the risk of Graves' disease. Pregnancy or recent childbirth may increase the risk of the disorder, particularly among women who have genes that increase their risk. Stressful life events or illness may act as a trigger for the onset of Graves' disease among people who have genes that increase their risk. People with other disorders of the immune system, such as type 1 diabetes or rheumatoid arthritis, have an increased risk. Graves' disease usually develops in people before age 40. Women are much more likely to develop Graves' disease than are men. Because a family history of Graves' disease is a known risk factor, there is likely a gene or genes that can make a person more susceptible to the disorder. Risk factorsĪlthough anyone can develop Graves' disease, many factors can increase the risk of disease, including: Graves' ophthalmopathy can also occur even if there's no hyperthyroidism. But signs and symptoms of ophthalmopathy may appear years before or after the onset of hyperthyroidism. Graves' ophthalmopathy often appears at the same time as hyperthyroidism or several months later.
It appears that the same antibody that can cause thyroid dysfunction may also have an "attraction" to tissues surrounding the eyes. Graves' ophthalmopathy results from a buildup of certain carbohydrates in the muscles and tissues behind the eyes - the cause of which also isn't known. That means that TRAb overrides the normal regulation of the thyroid, causing an overproduction of thyroid hormones (hyperthyroidism). The antibody associated with Graves' disease - thyrotropin receptor antibody (TRAb) - acts like the regulatory pituitary hormone. Normally, thyroid function is regulated by a hormone released by a tiny gland at the base of the brain (pituitary gland). In Graves' disease - for reasons that aren't well understood - the immune system produces an antibody to one part of the cells in the hormone-producing gland in the neck (thyroid gland). The immune system normally produces antibodies designed to target a specific virus, bacterium or other foreign substance. Graves' disease is caused by a malfunction in the body's disease-fighting immune system.
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