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Graves' Disease and Research

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Updated December 09, 2003

What is it?
Graves' disease (known in Europe as Basedow's disease), also called diffuse toxic goiter or thyrotoxicosis, is the most common form of hyperthyroidism. It is an autoimmune disorder in which the body produces a thyroid stimulating antibody that causes the thyroid gland to excrete excessive amounts of thyroid hormone.

What are the symptoms?
The thyroid gland grows larger (goiter) as it produces more and more hormone. Common symptoms of hyperthyroidism include weight loss, nervousness, irritability, sweating, dislike of hot weather, shakiness, and rapid pulse. About 50% of patients have red, watery, bulging eyes (the actor Marty Feldman had a severe case).

How is it treated?
Since the thyroid is overactive, the treatments are aimed at slowing down its production of hormone. Radioactive iodine (taken in capsules) is the simplest treatment, but physicians generally do not like to use it in children. Antithyroid drugs prevent the thyroid from making hormone. Surgery to remove some or all of the thyroid gland provides a more permanent solution, but it is not usually the first treatment chosen.

Some of the research published in 2001 (Reference number at end of each summary)

Premature hair graying may predict reduced bone mineral density in Graves' disease - A study of 44 women with Graves' disease and 133 women without it showed that premature gray hair (>50% gray by 40 years old) was associated with lower bone density (more brittle bones) in the women with Graves' disease. (Premature gray hair had no connection with bone density in women without the disease.)(6)

Cigarette smoking affects medical treatment of Graves' disease - This study assessed the effects of smoking cessation on Graves' disease in 76 women who were taking antithyroid drugs. Of these women, 26 stopped smoking completely and 14 reduced their nicotine consumption by more than 75%. Of these 40 women considered quitters, 78% (31 women) had at least a 50% reduction in thyroid stimulating antibodies, and 73% experienced a remission of symptoms (compared to only 13% of the women who did not reduce their smoking).(1)

The effect of antithyroid drug pretreatment on changes in thyroid hormone levels after radioactive iodine treatment - 42 people with Graves' disease were split into two test groups. One group received antithyroid drugs before radioactive iodine treatment and one group did not. The study found that pretreatment with antithyroid drugs did not protect people against Graves' disease becoming worse after radioactive iodine treatment. The study authors stated that this finding supported the recommendation that most people with Graves' disease do not require antithyroid drugs prior to taking radioactive iodine.(4)

The effect of methimazole (Tapazole) pretreatment on the efficacy of radioactive iodine therapy in Graves' hyperthyroidism - This study was a 1-year follow-up done on two groups of people who had either been treated with methimazole prior to radioactive iodine (29 people) or had just received radioactive iodine (32 people). The study found no negative effects of pretreatment with methimazole, and after 1 year both groups were similar in terms of how many people had high, normal, or low thyroid hormone levels.(2)

Use of radioiodine in adolescent Graves' disease - Some physicians are reluctant to use radioactive iodine in children. This study reported the use and excellent short-term results of using radioactive iodine in five children with Graves' disease.(7)

Use of cold iodine in patients with Graves' disease - This study reviewed the medical records of 280 people with Graves' disease who, after having radioactive iodine, were treated with cold (non-radioactive) iodine. The authors found that this treatment was safe and effective. They also found that the people who received antithyroid drugs before the radioactive iodine had a 2.3-fold higher treatment failure rate.(5)

Neonatal hyperthyroidism in infants of mothers with Graves' disease - The production of thyroid stimulating antibodies can continue even after the thyroid gland has been removed or destroyed. This study examined 3 newborns whose mothers had had most of their thyroid glands removed to treat Graves' disease. Despite the treatment, all three babies were born with hyperthyroidism because of their mothers' active antibodies.(3)

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