What Is Basedow’s Disease?

A type of hyperthyroidism, or an over-active thyroid

Basedow’s disease occurs when the thyroid gland produces too much thyroid hormone, known as hyperthyroidism. This autoimmune disease is also called Graves’ disease.

The thyroid is a butterfly-shaped gland that sits in the front of your throat. It produces hormones that regulate many critical functions in your body, including your metabolism and brain function. 

Symptoms of Basedow's disease can be wide-ranging, including anxiety, diarrhea, and skin abnormalities. However, there are safe and effective treatment options that help most people with this condition live long, full lives.

a woman holding her thyroid

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Types of Basedow’s Disease

The hypothalamus and pituitary gland in your brain work together to control thyroid hormone production. Cellular messages tell the hypothalamus when levels are low, and the hypothalamus tells the pituitary to release thyroid-stimulating hormone, or TSH.

As the name suggests, TSH stimulates the thyroid, telling it to increase hormone production. In Basedow's disease, your immune system attacks TSH receptors, which cells use to communicate messages. Your thyroid can’t tell the difference between the attack and the messages that come through those same receptors. 

As a result, the gland thinks the pituitary gland is sending messages that tell it to increase hormone levels, so it does. And because the receptors keep getting attacked, your thyroid just keeps pumping out the hormone.

What Is an Autoimmune Disease?

Autoimmune disease is “friendly fire” inside your body. The immune system is supposed to keep you healthy by destroying dangerous invaders like viruses, bacteria, fungi, and parasites. In autoimmunity, the immune system mistakenly identifies healthy tissues as foreign invaders.

Basedow’s disease can present in a couple of different ways based on what complications it causes. These complications are called:

Graves’ Ophthalmopathy

Basedow’s disease affects the eyes of between 25% and 50% of the people who have the condition. Common symptoms of Graves’ ophthalmopathy include:

  • Puffiness and inflammation around the eyes
  • Redness
  • Dry eyes
  • Irritation
  • Gritty sensation
  • Bulging eyes due to puffiness and retracting eyelids

In fewer than 10% cases, more serious eye problems develop, such as:

Graves’ Dermopathy

Graves’ dermopathy affects the skin. Only a small percentage of people with Basedow’s ever have it. This symptom is also called pretibial myxedema.

Symptoms strike the shins and sometimes the tops of your feet. The skin there gets thick, red, and lumpy. Graves’ dermopathy usually doesn’t cause any pain, but it may in some people.

Basedow’s Disease Symptoms

Basedow’s disease causes the same primary symptoms as other types of hyperthyroidism. They can include:

  • Fast, irregular heartbeat and palpitations
  • Diarrhea or frequent bowel movements
  • Goiter, or an enlarged thyroid
  • Heat intolerance
  • Nervousness and irritability
  • Fatigue
  • Muscle weakness
  • Tremor in the hands
  • Moist, smooth skin
  • Difficulty sleeping
  • Unintended weight loss
  • Irregular menstrual cycles and heavy periods

Complications

Graves’ ophthalmopathy and dermopathy are unique to Basedow’s disease. Other complications include:

These complications typically only develop in people who aren’t properly treated or have severe disease and aren't properly treated.

Your are at higher risk of developing other autoimmune conditions if Basedow's disease is present. Some that have occurred alongside Basedow’s include:

Causes

So far, the exact causes of Basedow’s disease aren’t fully understood. Based on growing evidence, though, researchers believe it’s a combination of genetics plus a triggering event, such as:

  • Viral or bacterial illness
  • Hormonal shifts, such as those during menopause
  • Certain medications
  • Iodine excess 

Iodine is an essential ingredient in thyroid hormones, so if you don’t have enough iodine, your body can’t make them.

Risk Factors

Factors that increase your risk of developing Basedow’s disease are:

  • Being assigned female at birth
  • Being between the ages of 30 and 50 
  • Having another autoimmune disease 

But anyone can develop Basedow’s, including young children and people of any sex.

Diagnosis

Diagnosing Basedow’s disease involves the following:

  • Physical exam: You may have several symptoms your doctor can see during a simple examination, including rapid heartbeat, tremor, skin changes, heightened reflexes, and an enlarged thyroid gland.
  • Blood tests: The doctor will look at your levels of TSH and thyroid hormones. They may also check for a type of thyroid antibodies called thyrotropin receptor antibodies (TRAbs) and thyroid stimulating immunoglobulin (TSI). Antibodies are produced by the immune system in response to a foreign body or threat in the body.
  • Imaging: Sometimes, a thyroid scan can detect overactivity, goiter, or an inflamed thyroid. It may also measure the gland’s uptake of iodine (called a radioactive iodine uptake test or RAIU.)

Treatment

Treatments for Basedow’s disease are aimed at lowering thyroid activity. The primary treatments are:

Anti-Thyroid Medications

Medications can make the thyroid unable to use iodine to make thyroid hormones. Common drugs that can do this include:

  • Tapazole (methimazole)
  • Propycil (propylthiouracil)

Tapazole is the preferred first-line treatment for Basedow's disease in children and teenagers. Propycil is considered the safest choice early in pregnancy.

Radioactive Iodine

This treatment destroys thyroid tissue to reduce hormone production. You swallow a solution containing radioactive iodine and your thyroid absorbs it like it does most of the iodine in your body. Radiation builds up in the tissue and destroys them.

This is considered a cure for Basedow’s. But it often leads to thyroid hormone levels that are too low, or hypothyroidism, which means you need to take synthetic thyroid hormones like levothyroxine in order to have enough.

The word “radioactive” sounds ominous, but this treatment has been shown to be safe. In the U.S., more than 70% of people with hyperthyroidism get this treatment. This treatment is often called radioiodine to make it sound less scary.

Symptoms of Low Thyroid Hormone

Hypothyroidism symptoms include:

  • Fatigue
  • Weight gain
  • Puffy face
  • Cold intolerance
  • Joint and muscle pain
  • Dry skin and hair
  • Hair loss
  • Decreased sweating
  • Irregular menstrual periods
  • Fertility problems
  • Slow heart rate
  • Goiter

Surgery

Surgery for Basedow’s involves removing most or all of your thyroid gland. This is also a cure for hyperthyroidism, but since your body can no longer make thyroid hormones, it causes hypothyroidism.

That means you need to take synthetic thyroid hormones for the rest of your life. Typically, they’re taken in pill form once a day. That gives you and your healthcare provider control over your thyroid levels so you can maintain them in a healthy range.

Summary

Basedow’s disease, also called Graves’ disease, causes high levels of thyroid hormones, which speeds up your metabolism and leads to myriad symptoms. The disease is likely triggered by a combination of genetic and environmental factors, including psychological stress and acute illness. Treatment of Basedow’s involves either blocking thyroid function with medications or curing the hyperthyroidism by destroying or removing thyroid tissues.

Frequently Asked Questions

What does the thyroid do?

Your thyroid gland produces two hormones: triiodothyronine (T3) and thyroxine (T4). These hormones are used to regulate your metabolic rate. That determines your body temperature, how fast your heart beats, your blood pressure, how quickly food passes through your digestive tract, the balance of other hormones, and much more.

What triggers Basedow’s disease?

Many things appear to trigger Basedow's disease, also known as Graves’ disease, in people who are genetically susceptible, including viral or bacterial illness, hormonal changes such as those that occur during puberty, pregnancy, childbirth, or menopause, psychological stress, some medications, and iodine deficiency. Basedow’s disease is ten times more common in women than men.

Is Basedow’s disease curable?

Yes, Basedow’s disease is curable, either through radioactive iodine treatments or surgical removal of part or all of the thyroid. Many people who are cured this way, though, end up with not enough thyroid hormones. It’s common to need thyroid hormone supplements after these types of treatment.

A Word From Verywell

The thyroid gland is critical to keeping your body functioning and healthy. Symptoms can be not only unpleasant but unsettling, as well. The good news is that thyroid disease is relatively easy to diagnose, and several safe and effective treatments are available. You may never be completely free of thyroid medication and occasional symptoms. However, proper treatment can get you back to feeling good and living fully.

By keeping your regular medical appointments and getting blood tests when your healthcare provider recommends them, you can stay on top of your thyroid hormone levels and protect your health.

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Article Sources
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  2. National Organization for Rare Disorders. Graves’ disease. Updated 2016.

  3. MedlinePlus. Graves disease. Updated August 18, 2020.

  4. National Institutes of Health, National Institutes of Diabetes and Digestive and Kidney Diseases. Graves’ disease. Updated September 2017.

  5. American Thyroid Association. Hyperthyroidism (overactive).