Graves' disease natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Natural History, Complications and Prognosis

Graves disease often responds well to treatment. However, thyroid surgery or radioactive iodine usually will cause hypothyroidism. Without getting the correct dose of thyroid hormone replacement, hypothyroidism can lead to:

• Depression
• Mental and physical sluggishness
• Weight gain

Antithyroid medications can also have serious side effects.

Complications

• Complications from surgery, including:
  • Hoarseness from damage to the nerve leading to the voice box
  • Low calcium levels from damage to the parathyroid glands (located near the thyroid gland)
  • Scarring of the neck
• Eye problems (called Graves ophthalmopathy or exophthalmos
• Heart-related complications, including:
  • Rapid heart rate
  • Congestive heart failure (especially in the elderly)
  • Atrial fibrillation
• Thyroid crisis (thyrotoxic storm), a severe worsening of overactive thyroid gland symptoms
• Increased risk for osteoporosis, if hyperthyroidism is present for a long time
• Complications related to thyroid hormone replacement
  • If too little hormone is given, fatigue, weight gain, high cholesterol, depression, physical sluggishness, and other symptoms of hypothyroidism can occur
  • If too much hormone is given, symptoms of hyperthyroidism will return