There is no cure for Graves disease, so the best treatment for you will likely be a combination of medications and lifestyle changes to reduce the symptoms. If you are unable to tolerate the drugs well, you may also consider surgery to remove the thyroid gland, which is called a thyroidectomy. This condition may also affect the eyes of some patients, in which case your Graves disease treatment will also include lubricating eye drops, other medications, and possibly an eye muscle surgery.
The primary drugs used for Graves disease treatment are intended to reduce the production of a hormone called thyroxine, which is manufactured by the thyroid gland. Graves disease, a type of hyperthyroidism, causes the thyroid gland to make too much thyroxine. It does this because the immune system malfunctions and attacks the thyroid gland. An overabundance of thyroxine increases the body's metabolic rate, resulting in symptoms such as bulging or irritated eyes, heart palpitations, and fatigue. When you are diagnosed with Graves disease, write down a list of all of your symptoms to help your doctor develop the best Graves disease treatment plan for you.
Anti-thyroid medications, including methimazole and propylthiouracil, can reduce the production of hormones. These are typically used for only one to two years, because they present a risk of liver damage. A doctor will often recommend taking these drugs along with a radioactive iodine treatment. The thyroid gland will collect the radioactive iodine, which will cause the gland to shrink gradually and decrease symptoms. Patients should be aware that this Graves disease treatment can increase the risk of eye complications and a shortage of thyroid gland hormones, or hypothyroidism.
Those who experience symptoms like tremors and a rapid heartbeat may use beta blockers along with other treatments. Beta blockers, such as atenolol and metaprolol, will not address the overabundance of hormones, but they can alleviate some symptoms. Patients who have a heart condition or asthma may be unable to use beta blockers.
A surgical procedure to remove the thyroid gland may also be included in your Graves disease treatment plan. While complications from this surgery are uncommon, patients should be aware that they will need to take thyroxine hormone pills for the rest of their lives, as they will no longer have a thyroid gland to produce thyroxine. Without this hormone, hypothyroidism will develop, which can cause symptoms like depression, weight gain, and mental “fogginess.”
Graves' opthalmopathy occurs when the disease affects the eyes. If you experience this, your Graves disease treatment will also include eye drops to alleviate dry eyes, as well as medications to reduce eyeball swelling. An eye muscle surgery may be needed to fix the length of the eye muscles. When they are too short due to swelling from the disease, the eyes may not align properly.
In addition to medications and surgeries, consider some simple lifestyle changes to alleviate Graves disease symptoms. Wearing sunglasses outdoors and applying cool compresses to the eyes can help alleviate Graves' opthalmopathy. Applying hydrocortisone cream to the skin every day can help ease other symptoms, such as swelling and redness of the skin. Engage in an exercise routine that includes weight-bearing exercises to help maintain bone density, because Graves disease may lead to brittle bones. Some patients may also find that joining a support group helps them cope with their disease.
