Graves’ disease medications include antithyroids, beta-blockers, and radioactive iodine therapy. However, doctors may use different treatments for some people, as well as for thyroid eye disease.

Graves’ disease causes the immune system to attack the thyroid. The thyroid is a small gland in the front of the neck. It produces hormones that affect almost every organ in the body.

People with Graves’ disease have more thyroid hormones than their body needs, which is known as hyperthyroidism or an overactive thyroid.

They may experience several symptoms that vary and come and go over time. They can also have several severe complications. Treatments may vary for each person. These include medications, therapy, and surgery.

This article discusses medications and other treatments for Graves’ disease.

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Antithyroid medications help make hyperthyroid symptoms go away for a short time. They include two types of thionamide medications: Methimazole and propylthiouracil.

These medications stop the thyroid from producing too many thyroid hormones.

Healthcare professionals usually first prescribe a person methimazole, also known as Tapazole. It typically has fewer side effects and is more effective than other antithyroid medications.

People normally take this medication once daily. They will usually need to take it for 1 to 2 years or longer.

It may take weeks or months to reduce thyroid hormone levels to normal.

Read about Graves’ disease.

Beta-blockers do not directly affect the thyroid or help it to make less thyroid hormone. Instead, they act on other hormones to slow down the heart rate and reduce the effects of adrenaline.

This helps to relieve some hyperthyroid symptoms, such as:

  • tremors
  • rapid heartbeat
  • nervousness

Beta-blockers can reduce these symptoms within hours.

Learn more about beta-blockers and hyperthyroidism.

Radioactive iodine therapy is where a person takes radioactive iodine as a capsule or liquid they swallow.

The iodine then slowly eliminates the cells in their thyroid that produce thyroid hormone. It does not affect other parts of their body. It is an effective treatment for hyperthyroidism.

However, nearly everyone who has radioactive iodine therapy later develops hypothyroidism. This is where their thyroid does not produce enough thyroid hormone. However, hypothyroidism is easier to treat and produces fewer long-term health conditions than hyperthyroidism.

Healthcare professionals do not generally prescribe radioactive iodine therapy for people who are pregnant or nursing, as it may affect the infant.

Surgery for Graves’ disease removes some or all of the thyroid gland.

Healthcare professionals do not often use this treatment, however. They may use it if a person is pregnant and cannot take antithyroid medication.

People who have their whole thyroid removed must take thyroid medication for life. Some people with part of their thyroid removed may also need to do so.

Graves’ disease can cause the immune system to attack the muscles and other tissues around the eyes.

This is a condition known as thyroid eye disease (TED), or Graves’ ophthalmopathy (GO). Around 1 in 3 people with Graves’ disease develop TED.

Most people with TED have mild symptoms that include:

  • proptosis (bulging eyes)
  • gritty or irritated eyes
  • puffy eyes
  • eyelids that pull back more than usual or do not fully close
  • blurred or double vision
  • light sensitivity
  • eye pain or pressure in their eyes
  • in rare cases, loss of vision

TED may go away naturally. However, treatments can help manage TED symptoms, including:

  • Over-the-counter (OTC) eye drops: A type of treatment for dry or irritated eyes known as artificial tears. OTC gels and ointments may also help a person’s eyes feel better.
  • Prescription medication: These medications help reduce the swelling behind a person’s eyes. They may include steroids such as prednisone or other medications such as rituximab. Doctors can also prescribe a specific TED medication, teprotumumab (Tepezza).
  • Surgery: Surgeons may perform a procedure they call orbital decompression to enlarge a person’s eye socket. This helps move the eye to the correct position and relieves pressure on the optic nerve. They may also perform eyelid surgery if a person’s eyelids pull back too much.
  • Radiation treatment: This treatment helps to reduce swelling around a person’s eyes.
  • Stopping smoking: Smoking makes a person’s TED worse.
  • Prescription glasses: These help to fix double-vision symptoms.
  • Sunglasses: Doctors may recommend wearing sunglasses outside if a person is sensitive to light.
  • Other methods: Healthcare professionals may instruct people to raise their head higher than their body at night if they have puffy eyelids. This helps people sleep. If their eyelids do not close all the way, they may recommend taping them shut at night to prevent dry eye.

Learn more about treatment for thyroid eye disease.

What makes Graves’ disease worse?

Iodine supplements or eating foods that have large amounts of iodine may cause or worsen hyperthyroidism. These foods can include kelp, dulse, or other types of seaweed.

Smoking can make Graves’ disease or complications of the condition worse.

What does a Graves’ disease flare-up feel like?

People with hyperthyroidism from Graves’ disease may have a sudden and life threatening flare-up of symptoms. This is what doctors call a thyroid storm. People may experience symptoms including:

  • a high fever
  • trouble breathing
  • confusion, or be delirious
  • abdominal pain

A thyroid storm is a medical emergency. If a person thinks they or someone else is experiencing one, they should seek immediate medical attention.

People with Graves’ disease have thyroid glands that produce too much thyroid hormone. To treat symptoms, healthcare professionals may use antithyroid medications, beta-blockers, or radioactive iodine therapy. In some circumstances, they may use surgery to remove all or some of the thyroid.

One complication of Graves’ disease is thyroid eye disease. Healthcare professionals may use different treatments for this.

A person with Graves’ disease may have a sudden and life threatening flare-up of symptoms known as a thyroid storm. If so, they require immediate medical attention.