Understanding Life Expectancy and Prognosis with Graves' Disease

Understanding Graves' Disease Prognosis and Life Expectancy

Receiving a diagnosis of Graves' disease, an autoimmune disorder that leads to hyperthyroidism or an overactive thyroid, can be alarming and leave patients full of questions. One of the most common questions asked is: how long can you live with Graves' disease if left untreated?

What is Graves' Disease?

Graves' disease is an autoimmune disorder that causes the thyroid gland to become overactive and produce excess thyroid hormones. This leads to hyperthyroidism or thyrotoxicosis. Some of the common symptoms include:

• Anxiety, irritability, and mood swings
• Fatigue, muscle weakness, tremors
• Heat sensitivity and increased sweating
• Weight loss despite increased appetite
• Rapid or irregular heartbeat
• Enlargement of the thyroid gland (goiter)
• Bulging eyes (exophthalmos)

What Causes Graves' Disease?

While the exact cause is not known, Graves' disease is believed to occur when the immune system mistakenly attacks the thyroid gland. This causes the gland to overproduce thyroid hormones. There appears to be a genetic predisposition to developing Graves' as it often runs in families. Stress, pregnancy, and viral infections may trigger the onset of symptoms in genetically susceptible individuals.

How is Graves' Disease Diagnosed and Treated?

Graves' disease is usually diagnosed via blood tests that show high levels of thyroid hormones (T3 and T4) along with thyroid stimulating hormone receptor antibodies (TSI or TRAb). Imaging tests and radioiodine uptake scans may also be done. Once diagnosed, there are three treatment options:

1. Anti-thyroid medications to prevent thyroid hormone production
2. Radioactive iodine therapy to damage thyroid cells and reduce hormone output
3. Surgery to remove part or all of the thyroid gland

The choice of treatment depends on the patient's age, severity of symptoms, underlying health conditions, and personal preferences. Younger patients often start with anti-thyroid meds, while radioiodine and surgery are more common in older adults.

How Long Can You Live with Untreated Graves' Disease?

Left completely untreated, Graves' disease can ultimately be fatal. However, the length of time between onset of symptoms and death can vary substantially between patients. Some factors that influence prognosis include:

Age at Diagnosis

Younger patients generally have better outcomes and life expectancy. Without treatment, older patients are more likely to experience heart complications and congestive heart failure due to the excess thyroid hormones placing strain on the cardiovascular system.

Overall Health Status

Patients with well-controlled diabetes, healthy blood pressure, normal cholesterol levels, and no underlying heart or kidney disease tend to live longer than those with additional health issues. Good health provides reserves to cope with the metabolic effects of prolonged hyperthyroidism.

Disease Severity

Patients with milder forms of Graves' disease and lower thyroid hormone levels may survive longer without treatment compared to those with extremely high hormone concentrations and severe symptoms.

Genetic Factors

In some families, Graves' disease may be associated with more aggressive autoimmune abnormalities. HLA genes are one example that can influence disease severity and outcomes.

What Are the Complications of Untreated Graves' Disease?

Leaving Graves' disease untreated allows thyroid hormone levels to remain elevated indefinitely. This can lead to significant short and long-term complications.

Thyroid Storm

Also known as thyroid crisis, this is a sudden, life-threatening exacerbation of hyperthyroidism. Triggers include infections, surgery, pregnancy, and certain medications. Thyroid storm requires emergency treatment and intensive care with a mortality rate of 20-30% if not treated promptly.

Osteoporosis

Years of untreated hyperthyroidism often lead to bone loss and osteoporosis, increasing fracture risk. This is more common in post-menopausal women who already have accelerated bone loss.

Heart Problems

The strain of prolonged hyperthyroidism can result in a rapid and irregular heart rhythm called atrial fibrillation. Heart failure due to cardiomyopathy is also a longer term risk if thyroid levels are not controlled.

Vision Changes

Some patients develop significant bulging of the eyes (exophthalmos) and vision problems such as double vision. Very severe eye protrusion can lead to loss of vision from exposure injuries.

Thyroid Growths and Cancer Risk

Long-standing thyroid overactivity is associated with an increased likelihood of nodules and thyroid cancer over time. However, cancer tends to be less aggressive when arising in hyperfunctioning thyroid tissue.

What is the Life Expectancy if Graves' Disease is Treated?

The good news is that the prognosis for Graves' disease is excellent with proper treatment. Once diagnosed, starting appropriate therapy for the individual patient can restore quality of life and eliminate the health risks associated with prolonged uncontrolled hyperthyroidism. So what is the life expectancy after treatment?

Response to Treatment Varies

Some patients with Graves' disease achieve remission after a course of anti-thyroid medication alone. Others need either radioiodine therapy or thyroidectomy to control symptoms long-term. A few patients experience lingering effects like dry eyes and joint pains despite normalized thyroid function.

Most Achieve Normal Life Expectancy

The majority patients treated for Graves' disease go on to live a normal lifespan without limitation. By managing the condition and remaining under medical care, they avoid the cardiovascular, skeletal, and vision complications that negatively impact prognosis.

Pregnancy Often Brings Remission

Younger women diagnosed with Graves' disease often go into remission during pregnancy. After giving birth, about 30% remain disease-free over the long term. However, postpartum thyroiditis can also occur.

Recurrence Possible for Some

Unfortunately Graves' disease can recur even after a prolonged remission. This is more likely if the thyroid gland was not completely removed via surgery initially. Patients who underwent radioiodine treatment also have a 20-30% chance of developing lifelong hypothyroidism within the first year requiring thyroid hormone replacement.

Living Well with Graves' Disease

Learning to manage Graves' disease activity, recognize signs of recurrence, and stick with long term treatment and monitoring provides the best opportunity for normal lifespan with minimal impact on overall health and well-being.

Take Medications Consistently

Carefully follow your doctor’s recommendations for any prescribed antithyroid medications, beta blockers for heart symptoms, calcium and Vitamin D to protect bones, and thyroid hormone replacements if needed.

Make Follow-Up Appointments

See your endocrinologist for periodic blood work and scans to ensure thyroid levels remain stable within the normal range.

Manage Stress

Finding healthy stress relief through yoga, meditation, counseling, or other activities can help avoid immune flare ups and recurrence of disease activity.

Stay Active and Eat Nutritious Foods

Regular exercise and a balanced diet support overall health and normal body weight, fueling resilience against lasting impacts from years of thyroid imbalance.

The Bottom Line

Left completely untreated, Graves' disease shortens lifespan and leads to disabling complications impacting multiple organ systems. However, achieving sustained control of thyroid function through medication, radioiodine ablation, or surgery can fully restore quality and quantity of life for people with this condition.

Commitment to long term treatment and lifestyle measures offers the best prognosis. By recognizing and managing flares if they occur, most patients live a normal lifespan and avoid any permanent end organ damage from years of hyperthyroidism.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.