evidence & education - scientific literature & patient education texts | oneGRAVESvoice

welcome to oneGRAVESvoice

- a positively charged Graves' disease and thyroid eye disease community.
  • join today!

Your Guide to Understanding Graves’ Disease

Genetics Home Reference - National Library of Medicine

Graves disease is a condition that affects the function of the thyroid, which is a butterfly-shaped gland in the lower neck. The thyroid makes hormones that help regulate a wide variety of critical body functions. For example, thyroid hormones influence growth and development, body temperature, heart rate, menstrual cycles, and weight. In people with Graves disease, the thyroid is overactive and makes more hormones than the body needs. The con...

You and Your Hormones: Thyroid Eye Disease

You & Your Hormones/Society for Endocrinology

Thyroid eye disease is an autoimmune condition affecting the eyes that is associated with Graves’ disease. Graves’ disease is an autoimmune thyroid condition.   What Causes Thyroid Eye Disease? The exact cause of thyroid eye disease is not known but it is thought to be caused by an abnormal immune response that is targeted at the healthy tissues of the eye. This leads to the eyes becoming sore, watery, swo...

Which Factors Predict the Outcome of Radioactive Iodine Therapy of Graves’ Disease?

Clinical Thyroidology for the Public

Graves’ disease is the most common cause of hyperthyroidism in the United States. Graves’ disease can be treated with medication (anti-thyroid drugs), surgery or radioactive iodine therapy. While the idealistic aim for treatment is to leave the patient with normal thyroid function long term, this is difficult to attain. In Europe and Asia, anti-thyroid drugs are frequently used as a first choice treatment. However, many patients wi...

What’s Wrong With Me?

Graves' Disease & Thyroid Foundation

Have you felt tense and irritable? Have you had trouble concentrating? You are not alone. If you have ever wondered whether your change in mood or thinking problems might be due to your Graves’ disease, keep reading. We are going to describe the emotional, behavioral and cognitive changes that may result from having Graves’ disease. Graves’ Related Emotional and Behavioral Symptoms Changes in emotion and b...

Understanding Your Blood Test

Graves’ Disease & Thyroid Foundation

Thyroid lab testing is an area that can be confusing to both patients and physicians. It is a subject of controversy since some people have suggested that standard thyroid lab testing is not reliable and that alternative measures, such as axillary temperatures, or some sort of compilation of symptoms, would be more reliable in diagnosing thyroid dysfunction or monitoring thyroid therapy. In fact, thyroid testing is an essential compone...

Understanding Unapproved use of Approved Drugs “Off Label” | U.S. Food & Drug Administration

U.S. Food & Drug Administration

Has your healthcare provider ever talked to you about using an FDA-approved drug for an unapproved use (sometimes called an “off-label” use) to treat your disease or medical condition? It is important to know that before a drug can be approved, a company must submit clinical data and other information to FDA for review. The company must show that the drug is safe and effective for its intended uses. “Safe” does not mean that th...

view all (110)

Which Factors are Associated With Quality of Life in Patients With Graves’ Orbitopathy Presenting for Orbital Decompression Surgery?

Eye

Purpose: Graves’ orbitopathy (GO) is associated with changes in the appearance of the eyes and visual dysfunction. Patients report feeling socially isolated and unable to continue with day-to-day activities. This study aimed at investigating the demographic, clinical, and psychosocial factors associated with quality of life in patients presenting for orbital decompression surgery. Methods:...

What are the Psychosocial Outcomes of Treatment for Thyroid Eye Disease? A Systematic Review

Thyroid: Official Journal of the American Thyroid Association

Background: Thyroid eye disease (TED) causes a number of esthetic and visual problems, and its treatment requires close clinical assessment, often for several years. There is evidence to suggest that clinical factors are poor indicators of patient-reported outcomes after treatments that aim to improve appearance, vision, or both. Psychosocial factors can impact on both adjustment to living with TED and also patients’ pe...

Weight Gain After Treatment of Graves’ Disease in Children

Clinical Endocrinology

Objective: The frequency of and risk factors for weight gain in children treated for Graves’ disease have not been described. We evaluated change in BMI-Z score and predictors of weight gain in this population. Design: Retrospective review of data from January 2000 to July 2011. Patients: Two hundred and twenty two children and adolescents with Graves’ dise...

Vitamin D and Graves’ Disease: A Meta-Analysis Update

Nutrients

The association between vitamin D levels and Graves’ disease is not well studied. This update review aims to further analyze the relationship in order to provide an actual view of estimating the risk. We searched for the publications on vitamin D and Graves’ disease in English or Chinese on PubMed, EMBASE, Chinese National Knowledge Infrastructure, China Biology Medical and Wanfang databases. The standardized mean difference (SMD) and 95%...

Update on Graves’ Disease: Advances in Treatment of Mild, Moderate and Severe Thyroid Eye Disease

Current Opinion in Ophthalmology

Purpose of Review: To report the most recent therapeutic advances of thyroid eye disease (TED) and offer general recommendations for management of TED. Recent Findings: Treatment of Graves ophthalmopathy is traditionally based on the use of high doses of corticosteroids and/or radiotherapy (RT) to decrease the activity of the disease, with the subsequent proptosis, strabismus and eyelid d...

Type 2 Diabetic Patients With Graves’ Disease Have More Frequent and Severe Graves’ Orbitopathy

Nutrition, Metabolism, and Cardiovascular Diseases

Background and Aims: Due to the worldwide increasing prevalence of diabetes (DM), patients with both diabetes and Graves’ disease (GD) have become more frequent. Sporadic reports indicate that Graves’ orbitopathy (GO), a GD complication that affects orbital soft tissues, can be severe in DM patients. The relationship between these diseases is not well understood. This study aims at evaluating the association of GD and G...

view all (201)

The Brazilian Consensus for the Diagnosis and Treatment of Hyperthyroidism: Recommendations by the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism

Arquivos Brasileiros de Endocrinologia e Metabologia

Introduction: Hyperthyroidism is characterized by increased synthesis and release of thyroid hormones by the thyroid gland. Thyrotoxicosis refers to the clinical syndrome resulting from excessive circulating thyroid hormones, secondary to hyperthyroidism or due to other causes. This article describes evidence-based guidelines for the clinical management of thyrotoxicosis. Objective: This...

The 2016 European Thyroid Association/European Group on Graves’ Orbitopathy Guidelines for the Management of Graves’ Orbitopathy

European Thyroid Journal

Graves’ orbitopathy (GO) is the main extrathyroidal manifestation of Graves’ disease, though severe forms are rare. Management of GO is often suboptimal, largely because available treatments do not target pathogenic mechanisms of the disease. Treatment should rely on a thorough assessment of the activity and severity of GO and its impact on the patient’s quality of life. Local measures (artificial tears, ointments and dark glasses) and control...

Management of Patients With Graves’ Orbitopathy: Initial Assessment, Management Outside Specialised Centres and Referral Pathways

Clinical Medicine: Journal of the Royal College of Physicians of London

Graves’ orbitopathy (GO) is uncommon, but responsible for considerable morbidity. A coordinated approach between healthcare professionals is required in order to meet the needs of patients. Early diagnosis can be achieved by a simple clinical assessment. Low-cost effective interventions can be initiated by generalists, which may improve outcomes. Moderate-to-severe GO should be referred to specialised centres. Recommendations for clinical diag...

Effects of Treatment Modalities for Graves’ Hyperthyroidism on Graves’ Orbitopathy: A 2015 Italian Society of Endocrinology Consensus Statement

Journal of Endocrinological Investigation

Graves’ disease is the most frequent form of hyperthyroidism in iodine sufficient countries, and Graves’ orbitopathy (GO) is its most important and common extrathyroidal manifestation, affecting about 25 % of patients. Although GO is generally mild and rarely progressive, thyroid dysfunction, both hyperthyroidism, and hypothyroidism, can influence its course. GO has been reported to improve after correction of hyperthyroidism with antithyr...

Consensus Statement of the European Group on Graves’ Orbitopathy (EUGOGO) on Management of Graves’ Orbitopathy

Thyroid : Official Journal of the American Thyroid Association

Graves’ orbitopathy (GO) constitutes a major clinical and therapeutic challenge. GO is an autoimmune disorder representing the commonest and most important extrathyroidal manifestation of Graves’ disease, but it may occur in patients without current or prior hyperthyroidism (euthyroid or ophthalmic Graves’ disease) or in patients who are hypothyroid due to chronic autoimmune (Hashimoto’s) thyroiditis. Although the pathogenesis of GO (5...

2018 European Thyroid Association Guideline for the Management of Graves’ Hyperthyroidism

European Thyroid Journal

Graves’ disease (GD) is a systemic autoimmune disorder characterized by the infiltration of thyroid antigen-specific T cells into thyroid-stimulating hormone receptor (TSH-R)-expressing tissues. Stimulatory autoantibodies (Ab) in GD activate the TSH-R leading to thyroid hyperplasia and unregulated thyroid hormone production and secretion. Diagnosis of GD is straightforward in a patient with biochemically confirmed thyrotoxicosis, positive TSH-...

view all (8)

Structural Brain Changes in Graves’ Hyperthyroidism may be of Autoimmune Origin

Thyroid

In Graves’ disease (GD), brain-derived symptoms are prevalent. During the hyperthyroid state, the volumes of medial temporal lobe (MTL) structures, e.g. the hippocampi, are reduced. This has been attributed to the high thyroid hormone levels, but we hypothesize that the structural changes and mental symptoms may be due to autoimmunity per se. Here, autoimmunity directly related to the thyroid as well as other autoimmunity may be impo...

Rituximab and IVIG for Graves’ Dermopathy, Do They Work?: A Case Series

Endocrine Society

Background: Graves’ dermopathy (GD) is a rare autoimmune manifestation of Graves’ disease, almost always occurring in those with Graves’ orbitopathy (GO). GD is speculated to have the same basic pathogenesis as GO characterized by fibroblast proliferation and glycosaminoglycan accumulation, and in GD progression to lymphedema. This is thought to be mediated by TSH-receptor sensitized T cells infiltrating the skin...

Review of the Literature and Report of a Large Series of Patients Regarding the Association of Other Autoimmune Diseases in Patients With Graves’ Disease (With/Without Graves’ Ophthalmopathy)

Thyroid

Several studies have reported an association between autoimmune thyroid disorders and other autoimmune disorders. We have focused on the prevalence of autoimmune diseases in subjects affected by Graves’ Disease (GD) with/without Graves’ ophthalmopathy (GO). Three thousand and two hundred-nine patients with GD were prospectively evaluated regarding the appearance of other autoimmune disorders, with respect to three age (+/- 5 years)...

Reversible Pulmonary Hypertension and Clinical Right Heart Failure Associated With Graves’ Disease

Journal of the American College of Cardiology

Background: Heart failure is typically seen in patients with hyperthyroidism because of longstanding untreated disease with or without concomitant atrial fibrillation with rapid ventricular rates at an average reported age of 66 years. Approximately 6% of hyperthyroid patients have left heart failure but isolated right heart failure with associated pulmonary hypertension is not commonly seen in hyperthyroidism....

Recurrence of Graves’ Disease is Predicted by Lower Patient Age at Initial Diagnosis: Implications for Care

Endocrine Society

One of the greatest challenges in managing Graves’ disease (GD) is the high recurrence of hyperthyroidism after achieving remission. Approximately 50-80% of individuals with GD who do not have definitive treatment with either radioactive iodine or thyroidectomy will experience disease recurrence. Although some evidence suggests that male gender, smoking, and geographical variation may contribute to the risk of recurrence, the factors that af...

Radioiodine Therapy for Juvenile Graves’ Disease: A Single Institution Experience in Japan (Poster 317)

Thyroid

131I radioiodine therapy (RIT) has been applied for juvenile Graves’ disease (GD) in the United States for a long time. However, RIT for juvenile GD has been avoided because of the potential risk of tumorigenesis in Japan. There have been few reports regarding RIT for juvenile GD in Japan. Therefore, we reviewed juvenile GD patients treated with RIT in our thyroid specialty clinic. We reviewed the medical records of 493 GD patients u...

view all (20)

Trial of Rituximab for Graves’ Ophthalmopathy

U.S. National Library of Medicine

Brief Summary: This study is being done to investigate the effects (good and bad) of Rituximab for the treatment of an autoimmune eye disease called Graves’ ophthalmopathy. This disease has proven to be difficult to treat. Rituximab is a monoclonal antibody that depletes a line of cells involved in the autoimmune response. The study hypotheses is that rituximab is effective in the treatment of patients with moderate to...

Thyroid Disorders and Diseases, an Issue of Medical Clinics, 1st Edition

Elsevier

This issue of Medical Clinics of North America provides the latest essential updates on thyroid disorders and diseases. Topics covered include the following: thyroid synthesis and physiology; hyperthyroidism; hypothyroidism; thyroid nodules; goiter; differentiated thyroid cancer; subacute, silent, and postpartum thyroiditis; thyroid and pregnancy; thyroid and the elderly; medications and thyroid hormones; thyroid and the heart; thyroid and lip...

Study of RVT-1401 for the Treatment of Patients With Moderate to Severe Active Graves’ Ophthalmopathy

U.S. National Library of Medicine

The purpose of the current study is to confirm safety/tolerability and key pharmacodynamic (PD) effects that are considered to drive clinical benefit in GO patients.    Primary Outcome Measure:  • Assessment of safety by analysis of adverse events (AEs) data [ Time Frame: 7 Weeks ] AE summaries of the number and percent of participants reporting each event at least once will be generated. Other saf...

Recent Developments in Graves’ Ophthalmopathy

Springer

Recent Developments in Graves’ ophthalmopathy offers an overview of the pathogenesis, assessment and management of patients with thyroid-associated eye disease. Each chapter is written by an expert and truly represents the current state of the art on the particular topic. This book can therefore almost be considered a textbook on this enigmatic disorder. Recent developments in Graves’ ophthalmopathy is designed for all those interested...

Most Patients With Graves’ Disease Treated With Antithyroid Drugs Eventually Require Additional Therapies

American Thyroid Association

Graves’ disease is the most common cause of hyperthyroidism (overactive thyroid). It usually affects people between 30-60 years of age and is much more common in women than men. Patients with Graves’ disease, often have enlarged thyroids (goiter) and bulging eyes (exophthalmos). There are three main options to treat Graves’ disease: antithyroid drugs (ATDs), radioactive iodine therapy and surgery. The most common ATDs in use are...

Graves’ Orbitopathy

Family Practice Notebook

Epidemiology: Eye complications occur in 25-50% of Grave’s disease. Pathophysiology: Grave’s disease induced eye changes:    • Sensitized orbital tissue-specific T-Lymphocytes    • Local inflammatory cellular infiltration of eye Orbital fibroblasts mediate changes:    • Adipose hypertrophy    • Glycosaminoglycan accumulates R...

view all (9)