Symptom

In Graves’ disease from the past, the following three symptoms are considered representative symptoms.

Goiter
Exophthalmus
Symptoms caused by excess of thyroid hormone, such as palpitations
In fact, however, the patients who are experiencing these three symptoms are rather minority. Then, I will explain in detail about each symptom.

Goiter
A goiter refers to thyroid swelling.
Goiter has a “diffuse goiter” where the whole thyroid gland can be left intact, and “nodular goiter” where a partial lump can be made. In the case of Graves’ disease, it becomes the “diffuse goiter”.
Although the degree of swelling depends on people, in general, young people tend to be larger. In this case, the front of the neck bulged as a whole, it looks like the neck became thick. On the other hand, when you get older, the goiter tends to be small.

People with a large goiter tend to be difficult to treat with medicine, and it seems that they often become indications for surgery and radioactive iodine (iodine) treatment (isotope).

Exophthalmus
Frequently, Graves’ disease is said to be a disease that causes eye problems, but eyeball protrusion is not actually so much symptom. Compared with before the onset of illness, there are about two people in ten people who have eyes as they are clearly understood. Even if the eyeball does not protrude, the upper eyelid may come off (eyelid swelling) and the eyelids appear to have grown (eyelid retraction) as the eyelid is pulled towards the upper side. An eye abnormality due to Graves ‘disease is called Graves’ eye disease.
Eyelid retraction is often associated with hyperthyroidism and it may be better to normalize thyroid hormone with medicine. The eyeball protrudes because the volume of adipose tissue behind the eyeball and the volume of the muscles that move the eyeball increases due to inflammation and swelling. As a result, the eyeball is pushed forward. Usually the eyes only protrude, but in some cases the cornea and conjunctiva become red, ulcers are formed and pain may be involved. Some also say things look double. This is a symptom of ‘protruding malignant eyes’ but it is very rare. You do not have to worry too much if you receive appropriate treatment as soon as possible.

These eye symptoms do not necessarily match the extent of functional abnormality of the thyroid gland. Even if the hyperthyroidism is severe, there are some people who have no abnormality in their eyes, and conversely, even if their eyes are protruding, there are some people who are very light. Currently it is not well understood how abnormality of thyroid function and eyes bulge are related.
Therefore, even if the thyroid condition improves by treatment, the symptoms of the eye do not necessarily improve well. This is a troubling place of this symptom, but it can be expected that it will gradually become inconspicuous for a long time.
In our hospital, in cases where abnormality of eyes is conspicuous, we cooperate with a specialist to treat, and treatment results have improved recently.

Excess thyroid hormone
Among the symptoms associated with Graves’ Disease, it is the symptom caused by excess of thyroid hormone that has the greatest influence on everyday life.
Thyroid hormone is a hormone that activates the body’s metabolism. Therefore, patients with Graves’ disease who are in thyroid hormone excess status seem to be lively and glossy skin and looks fine.
However, abnormally active metabolism means wasteful energy waste. For example, keep in mind that you consume energy as much as you are running while you are still. Anyway, I am tired easily, I always have trouble, because I have many symptoms in this sick person.

Figure 1 at the bottom right lists the symptoms before treatment for patients visiting our hospital. Both are symptoms due to hyperfunction of the thyroid gland.
Above all, typical symptoms are palpitations. There are many symptoms along with shortness of breath and some patients say that even though they are asleep they can not sleep because of palpitations. This is because in Graves’ disease the metabolism is accelerated, so more oxygen is needed than normal people. Patients with Graves’ disease are still in the same state of running as they are still, so you always have to work extra heart. That is the subjective symptom of palpitations. In a state of normal sitting, the pulse rate is about 60 to 80 in 1 minute, but in case of Graves’ disease patients it may exceed 100. However, there are times when the pulse rate does not increase when you get older.

Symptoms before treatment of Graves’ disease

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Other symptoms are hands and feet and the tremor of the body. Especially the tremor of the fingertip is conspicuous, it makes it difficult to write letters, and sometimes spills at the time of drinking tea. Also, as it is in the same state as exercising all the time, it gets hot and it gets sweaty a lot.
Furthermore, because the consumption of energy is intense, it means that there is appetite but it can not be fattened or can be made faint. It is particularly conspicuous in men and those with a high age, and in severe cases it can be 10 kilograms in 1 to 2 months.

There are many other symptoms of Graves’ disease, such as diarrhea, itchy skin, muscle weakening, and so on.
Because the rhythm of the day is also slightly maddened, there are not a few people who have a bad startup and are having a bad condition all afternoon. Grade Disease is said to be said to be “a disease without good morning”, it is a disease that you can not feel morning in a good mood. In addition to this, symptoms such as mental instability, irritation, no concentration, and restlessness appear. As a result, the efficiency of work may be reduced, and in the case of children, school grades may decline suddenly. Because it is tired easily and mental stability is lost, it is a big minus for himself. No matter how much energy you set yourself on, the condition of your body can not be helped. In order to reduce such things, it is necessary to receive proper treatment.

■ Symptoms different depending on age
As mentioned above, Graves’ disease is accompanied by various symptoms, but there are individual differences in appearance, there are people who do not have too much subjective symptoms, some people are living in the same way as healthy people, others are weakened Some people are more symptomatic as they fall asleep.
In terms of age, young people generally have outstanding thyroid glands, but when they are over the age of 60, they are significantly less. For that reason, the elderly tend to have a delay in diagnosis if anything.
Also, the elderly have many thin skin, and young people seem to have a lot of fat people. This is probably because many young women eat more than energy consumption.
However, compared to the past, people who do not complain of symptoms or who have a light symptom have increased. This is thought to have a big impact on the environment. For example, summer is a painful season for hot weather patients, but recently it has become quite easy due to the spread of air conditioning. Also, as meals are also small, the number of calories can be sufficient enough, so the number of people who can be extremely reduced is also decreasing. From the point of view of many illnesses to women, the burden of housework is now lighter due to the spread of electrical appliances. For that reason, people are tired and can not satisfy their housework as well.
However, even those who are poor in subjective symptoms, if left untreated, the effect of hyperfunctioning of the thyroid appears in either body. Please remember that if you treat yourself while the symptoms are light, you will not lose your own quality of life.

First symptom of male in Graves’ disease

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Women’s initial symptoms in Graves’ disease

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■ Illness associated with Graves’ disease
Graves’ disease is not a worrisome disease if you receive proper treatment. However, if left unattended, it may cause serious complications. I will explain some complications below.

Heart disease
The most common complication is heart disease. Because the heart is forced to work excessively during thyroid hormone excess, the heart is exhausted for a long time, resulting in arrhythmia or heart failure due to heart failure. Especially, since the heart of the elderly is also affected by aging, attention is necessary.

Thyroid crisis
In addition to heart diseases, another thing that concerns life is the thyroid crisis. This may happen when the body is subjected to strong stress, for example when you have a big surgery with other diseases or a serious infection. When becoming a thyroid crisis, it is in a condition such as high temperature which can not be measured with a thermometer, intense tachycardia (150 or more per minute), diarrhea, fluish sweat, opacity of conscious state, unconsciousness or the like. In such a state, it was said that it was very dangerous in the past. Although the method of treatment is also progressing now, it still remains a dangerous state. However, recently there have been few people with Graves’ disease who have not received treatment, so few patients have become so badly conditioned.

Thyroid toxic periodic limb paralysis
Symptoms seen in men have symptoms of thyrotoxic periodic limb paralysis. This often seems to notice that limbs, especially legs, will not move when you wake up in the morning. Seizures will naturally resolve in a few hours at best, but it will happen over and over again. This symptom will not occur only by normalizing the concentration of thyroid hormone.

Hyperglycemia
It is not uncommon for Graves’ disease to have sugar in the urine. This is due to better dietary absorption, after hyperglycemia after eating and urine sugar is positive. Whether it is due to Graves’ disease or due to complicated diabetes mellitus, it is necessary to examine this by examination, but if it is caused by Graves’ disease, treatment with Graves’ disease will be better.

Besides, in rare cases, hair may easily come off, deformation of the nail, white spots of the skin may appear. There is also a symptom that part of the shin swelling and the color becomes black, saying the anterior tibia mucinous edema.