BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuGraves diseaseDiffuse thyrotoxic goiter; Hyperthyroidism - Graves; Thyrotoxicosis - Graves; Exophthalmos - Graves; Ophthalmopathy - Graves; Exophthalmia - Graves; Exorbitism - Graves; Graves' diseaseGraves disease is an autoimmune disorder that leads to an overactive thyroid gland (hyperthyroidism). An autoimmune disorder is a condition that occurs when the immune system mistakenly attacks healthy tissue.Autoimmune disorderAn autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...ImageRead Article Now Book Mark Article Causes The thyroid gland is an important organ of the endocrine system. The gland is located at the front of the neck above where the collarbones meet. This gland releases the hormones thyroxine (T4) and triiodothyronine (T3), which control body metabolism. Controlling metabolism is important for regulating mood, weight, and mental and physical energy levels.Endocrine systemEndocrine glands release (secrete) hormones into the bloodstream. The endocrine glands include:AdrenalHypothalamusIslets of Langerhans in the pancrea...ImageRead Article Now Book Mark Article ThyroxineT4 (thyroxine) is the main hormone produced by the thyroid gland. A laboratory test can be done to measure the amount of free T4 in your blood. Fre...ImageRead Article Now Book Mark Article TriiodothyronineTriiodothyronine (T3) is a thyroid hormone. It plays an important role in the body's control of metabolism (the many processes that control the rate...ImageRead Article Now Book Mark Article MetabolismMetabolism refers to all the physical and chemical processes in the body that convert or use energy, such as:BreathingCirculating bloodControlling bo...ImageRead Article Now Book Mark Article When the body makes too much thyroid hormone, the condition is called hyperthyroidism. (An underactive thyroid leads to hypothyroidism.)HyperthyroidismHyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.ImageRead Article Now Book Mark Article HypothyroidismHypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. This condition is often called underactive thyroid....ImageRead Article Now Book Mark Article Related video goes here for no-HTML5 browsersGraves disease is the most common cause of hyperthyroidism. It is due to an abnormal immune system response that causes the thyroid gland to produce too much thyroid hormone. Graves disease is most common in women over age 20. But the disorder can occur at any age and can affect men as well. Symptoms Younger people may have these symptoms:Anxiety or nervousness, as well as problems sleeping Breast enlargement in men (possible) Problems concentrating Fatigue Frequent bowel movements Hair loss Heat intolerance and increased sweating Heat intoleranceHeat intolerance is a feeling of being overheated when the temperature around you rises. It can often cause heavy sweating. Heat intolerance usually...Read Article Now Book Mark Article Increased appetite, despite having weight loss Increased appetiteIncreased appetite means you have an excess desire for food.ImageRead Article Now Book Mark Article Irregular menstrual periods in women Muscle weakness of the hips and shoulders Moodiness, including irritability and anger Palpitations (sensation of a strong or unusual heartbeat) PalpitationsPalpation is a method of feeling with the fingers or hands during a physical examination. The health care provider touches and feels your body to ex...ImageRead Article Now Book Mark Article Rapid or irregular heartbeat Shortness of breath with activity Shortness of breathBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Shaking hands (tremors) TremorsA tremor is a type of shaking movement. A tremor is most often noticed in the hands and arms. It may affect any body part, including the head, tong...ImageRead Article Now Book Mark Article Weight lossMany people with Graves disease have problems with their eyes:The eyeballs may seem to be bulging out and may be painful. Eyes can feel irritated, itchy, or tear more frequently. Double vision may be present. Decreased vision and damage to the cornea can also occur in severe cases.Older people may have these symptoms:Rapid or irregular heartbeat Irregular heartbeatAn arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...ImageRead Article Now Book Mark Article Chest pain Chest painAngina is a type of chest discomfort or pain due to poor blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium). T...Read Article Now Book Mark Article Memory loss or decreased concentration Weakness and fatigue Exams and Tests During the physical exam, your health care provider may find:You have an increased heart rate Your thyroid gland may be enlarged (goiter)Other tests include:Blood tests to measure levels of thyroid stimulating hormone (TSH), T3, and free T4 Radioactive iodine uptake and scanRadioactive iodine uptakeRadioactive iodine uptake (RAIU) tests thyroid function. It measures how much radioactive iodine is taken up by your thyroid gland in a certain time...ImageRead Article Now Book Mark Article ScanA thyroid scan uses a radioactive iodine tracer to examine the structure and function of the thyroid gland. This test is often done together with a ...ImageRead Article Now Book Mark Article This disease may also affect the following test results:Orbit CT scan or ultrasound Orbit CT scanA computed tomography (CT) scan of the orbit is an imaging method. It uses x-rays to create detailed pictures of the eye sockets (orbits), eyes and ...ImageRead Article Now Book Mark Article Thyroid stimulating immunoglobulin (TSI) TSITSI stands for thyroid stimulating immunoglobulin. TSIs are antibodies that tell the thyroid gland to become more active and release excess amounts ...ImageRead Article Now Book Mark Article Thyroid peroxidase (TPO) antibody Anti-TSH receptor antibody (TRAb) Treatment Treatment is aimed at controlling your overactive thyroid. You may receive one or more types of treatment.Beta-blocker medicines may help treat:Rapid heart rate Sweating AnxietyThey may be given until the hyperthyroidism is controlled.Antithyroid medicines:Block or change how the thyroid gland uses iodine May be used to control the overactive thyroid gland before surgery or radioiodine therapy May be used as a long-term treatmentRadioactive iodine is given by mouth. It then concentrates in the overactive thyroid tissue and causes damage.Surgery may be done to remove the thyroid.If you have had radioactive iodine treatment or surgery, you will need to take replacement thyroid hormones for the rest of your life. This is because these treatments destroy or remove the gland.TREATMENT OF THE EYESSome of the eye problems related to Graves disease often improve after treatment with medicines (including selenium), radiation, or surgery. Radioiodine therapy can sometimes make eye problems worse. Eye problems are worse in people who smoke, even after the hyperthyroidism is treated.Sometimes, prednisone is needed to reduce eye irritation and swelling. Prednisone is a steroid medicine that suppresses the immune system. Other treatments to suppress the immune system may be needed. Ask your provider if these would help you.Sunglasses, cool compresses, and eye drops may reduce eye irritation. In rare cases, surgery or radiation therapy (different from radioactive iodine) may be needed to prevent further damage to the eye and loss of vision. Outlook (Prognosis) Graves disease often responds well to treatment. Thyroid surgery or radioactive iodine often will cause an underactive thyroid (hypothyroidism). Without getting the correct dosage of thyroid hormone replacement, hypothyroidism can lead to:Depression DepressionDepression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...ImageRead Article Now Book Mark Article Mental and physical sluggishness Weight gain Dry skin Constipation Cold intolerance Cold intoleranceCold intolerance is an abnormal sensitivity to a cold environment or cold temperatures.Read Article Now Book Mark Article Abnormal menstrual periods in women When to Contact a Medical Professional Contact your provider if you have symptoms of Graves disease or your eye problems or other symptoms get worse or do not improve with treatment.Go to the emergency room or call 911 or the local emergency number if you have symptoms of hyperthyroidism with: Decrease in consciousness Fever Rapid, irregular heartbeat Sudden shortness of breathOpen ReferencesReferencesHollenberg A, Wiersinga WM. Hyperthyroid disorders. In: Melmed S, Auchus RJ, Golfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 12.Pearce EN, Hollenberg AN. Thyroid. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 207.Smith JR, Wassner AJ. Thyrotoxicosis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 584.Weetman AP, Kahaly GJ. Graves disease. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 71.AllVideoImagesTogHyperthyroidismAnimation Related video goes here for no-HTML5 browsersHyperthyroidism - Animation You're restless and nervous. You feel hungry all the time, but no matter how much you eat, you keep losing weight. You can't sleep or concentrate, and you feel hot and sweaty. If symptoms like these are putting you on edge, the problem may be an overactive thyroid gland, or hyperthyroidism. This little butterfly-shaped structure in your neck is your thyroid gland. It's job is to release the hormones that help control your body's energy levels, a process known as metabolism. When you have hyperthyroidism, that little gland goes into overdrive, releasing too much of its hormones. Having too much thyroid hormone is like putting your body in fast forward, everything speeds up. That's why you feel shaky, hungry, and your heart feels like it's pounding. So, what causes hyperthyroidism? You can develop an overactive thyroid because you've gotten too much iodine, an element the thyroid uses to make its hormones. Or, you might have a growth on your thyroid that's causing the excess hormone production. But many people with hyperthyroidism have an autoimmune disorder called Graves disease, which also makes their eyes bulge out. During an exam, your doctor may notice that your thyroid is larger than normal, and that you have high blood pressure, tremors, or a fast heart rate. These can all be signs of hypothyroidism. You'll probably have a blood test to check the levels of your thyroid hormones. If you do have an overactive thyroid, you may need to take medicine to slow down the gland and its hormone production. Or, your doctor may suggest having surgery to remove some or all of the thyroid, or taking radioactive iodine to destroy it. If you have surgery or radioactive iodine treatment, you'll probably need to take thyroid hormones for the rest of your life to replace the ones your body can no longer make. You can't prevent hyperthyroidism, but once you have it, it's usually pretty easy to treat. With the right treatment you can finally be free from its symptoms. While you're being treated, watch out for an emergency condition called thyroid crisis, or thyroid storm, which can set in if you've been under a lot of stress or have an infection. If you have a fever, fast and unsteady heartbeat, or you feel less alert than usual, call your emergency services number or go to the ER right away.Endocrine glands - illustration Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).Endocrine glandsillustrationThyroid enlargement - scintiscan - illustration This image shows the enlargement of the thyroid gland and extension down behind the breastbone (retrosternal space). The image, called a scintiscan, was generated using a radioactive isotope.Thyroid enlargement - scintiscanillustrationGraves disease - illustration Graves disease is an autoimmune disorder that involves overactivity of the thyroid (hyperthyroidism). Hallmarks of the condition are bulging eyes (exophthalmos), heat intolerance, increased energy, difficulty sleeping, diarrhea and anxiety.Graves diseaseillustrationThyroid gland - illustration The thyroid gland, a part of the endocrine (hormone) system, plays a major role in regulating the body's metabolism.Thyroid glandillustrationHyperthyroidismAnimation Related video goes here for no-HTML5 browsersHyperthyroidism - Animation You're restless and nervous. You feel hungry all the time, but no matter how much you eat, you keep losing weight. You can't sleep or concentrate, and you feel hot and sweaty. If symptoms like these are putting you on edge, the problem may be an overactive thyroid gland, or hyperthyroidism. This little butterfly-shaped structure in your neck is your thyroid gland. It's job is to release the hormones that help control your body's energy levels, a process known as metabolism. When you have hyperthyroidism, that little gland goes into overdrive, releasing too much of its hormones. Having too much thyroid hormone is like putting your body in fast forward, everything speeds up. That's why you feel shaky, hungry, and your heart feels like it's pounding. So, what causes hyperthyroidism? You can develop an overactive thyroid because you've gotten too much iodine, an element the thyroid uses to make its hormones. Or, you might have a growth on your thyroid that's causing the excess hormone production. But many people with hyperthyroidism have an autoimmune disorder called Graves disease, which also makes their eyes bulge out. During an exam, your doctor may notice that your thyroid is larger than normal, and that you have high blood pressure, tremors, or a fast heart rate. These can all be signs of hypothyroidism. You'll probably have a blood test to check the levels of your thyroid hormones. If you do have an overactive thyroid, you may need to take medicine to slow down the gland and its hormone production. Or, your doctor may suggest having surgery to remove some or all of the thyroid, or taking radioactive iodine to destroy it. If you have surgery or radioactive iodine treatment, you'll probably need to take thyroid hormones for the rest of your life to replace the ones your body can no longer make. You can't prevent hyperthyroidism, but once you have it, it's usually pretty easy to treat. With the right treatment you can finally be free from its symptoms. While you're being treated, watch out for an emergency condition called thyroid crisis, or thyroid storm, which can set in if you've been under a lot of stress or have an infection. If you have a fever, fast and unsteady heartbeat, or you feel less alert than usual, call your emergency services number or go to the ER right away.Endocrine glands - illustration Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).Endocrine glandsillustrationThyroid enlargement - scintiscan - illustration This image shows the enlargement of the thyroid gland and extension down behind the breastbone (retrosternal space). The image, called a scintiscan, was generated using a radioactive isotope.Thyroid enlargement - scintiscanillustrationGraves disease - illustration Graves disease is an autoimmune disorder that involves overactivity of the thyroid (hyperthyroidism). Hallmarks of the condition are bulging eyes (exophthalmos), heat intolerance, increased energy, difficulty sleeping, diarrhea and anxiety.Graves diseaseillustrationThyroid gland - illustration The thyroid gland, a part of the endocrine (hormone) system, plays a major role in regulating the body's metabolism.Thyroid glandillustration Tests for Graves disease T3 testAntithyroglobulin antibody testRelated Information Hyperthyroidism(Condition)Endocrine glands(Special Topic)Free T4 test(Medical Test)T3 test(Medical Test)Metabolism(Special Topic)Hypothyroidism(Condition)Eyes - bulging(Symptoms)Pulse - bounding(Symptoms)Atrial fibrillation and atrial flutter(Condition)Hypothyroidism - InDepth(In-Depth) Review Date: 2/28/2024 Reviewed By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Graves diseaseDiffuse thyrotoxic goiter; Hyperthyroidism - Graves; Thyrotoxicosis - Graves; Exophthalmos - Graves; Ophthalmopathy - Graves; Exophthalmia - Graves; Exorbitism - Graves; Graves' diseaseGraves disease is an autoimmune disorder that leads to an overactive thyroid gland (hyperthyroidism). An autoimmune disorder is a condition that occurs when the immune system mistakenly attacks healthy tissue.Autoimmune disorderAn autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...ImageRead Article Now Book Mark Article Causes The thyroid gland is an important organ of the endocrine system. The gland is located at the front of the neck above where the collarbones meet. This gland releases the hormones thyroxine (T4) and triiodothyronine (T3), which control body metabolism. Controlling metabolism is important for regulating mood, weight, and mental and physical energy levels.Endocrine systemEndocrine glands release (secrete) hormones into the bloodstream. The endocrine glands include:AdrenalHypothalamusIslets of Langerhans in the pancrea...ImageRead Article Now Book Mark Article ThyroxineT4 (thyroxine) is the main hormone produced by the thyroid gland. A laboratory test can be done to measure the amount of free T4 in your blood. Fre...ImageRead Article Now Book Mark Article TriiodothyronineTriiodothyronine (T3) is a thyroid hormone. It plays an important role in the body's control of metabolism (the many processes that control the rate...ImageRead Article Now Book Mark Article MetabolismMetabolism refers to all the physical and chemical processes in the body that convert or use energy, such as:BreathingCirculating bloodControlling bo...ImageRead Article Now Book Mark Article When the body makes too much thyroid hormone, the condition is called hyperthyroidism. (An underactive thyroid leads to hypothyroidism.)HyperthyroidismHyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.ImageRead Article Now Book Mark Article HypothyroidismHypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. This condition is often called underactive thyroid....ImageRead Article Now Book Mark Article Related video goes here for no-HTML5 browsersGraves disease is the most common cause of hyperthyroidism. It is due to an abnormal immune system response that causes the thyroid gland to produce too much thyroid hormone. Graves disease is most common in women over age 20. But the disorder can occur at any age and can affect men as well. Symptoms Younger people may have these symptoms:Anxiety or nervousness, as well as problems sleeping Breast enlargement in men (possible) Problems concentrating Fatigue Frequent bowel movements Hair loss Heat intolerance and increased sweating Heat intoleranceHeat intolerance is a feeling of being overheated when the temperature around you rises. It can often cause heavy sweating. Heat intolerance usually...Read Article Now Book Mark Article Increased appetite, despite having weight loss Increased appetiteIncreased appetite means you have an excess desire for food.ImageRead Article Now Book Mark Article Irregular menstrual periods in women Muscle weakness of the hips and shoulders Moodiness, including irritability and anger Palpitations (sensation of a strong or unusual heartbeat) PalpitationsPalpation is a method of feeling with the fingers or hands during a physical examination. The health care provider touches and feels your body to ex...ImageRead Article Now Book Mark Article Rapid or irregular heartbeat Shortness of breath with activity Shortness of breathBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Shaking hands (tremors) TremorsA tremor is a type of shaking movement. A tremor is most often noticed in the hands and arms. It may affect any body part, including the head, tong...ImageRead Article Now Book Mark Article Weight lossMany people with Graves disease have problems with their eyes:The eyeballs may seem to be bulging out and may be painful. Eyes can feel irritated, itchy, or tear more frequently. Double vision may be present. Decreased vision and damage to the cornea can also occur in severe cases.Older people may have these symptoms:Rapid or irregular heartbeat Irregular heartbeatAn arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...ImageRead Article Now Book Mark Article Chest pain Chest painAngina is a type of chest discomfort or pain due to poor blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium). T...Read Article Now Book Mark Article Memory loss or decreased concentration Weakness and fatigue Exams and Tests During the physical exam, your health care provider may find:You have an increased heart rate Your thyroid gland may be enlarged (goiter)Other tests include:Blood tests to measure levels of thyroid stimulating hormone (TSH), T3, and free T4 Radioactive iodine uptake and scanRadioactive iodine uptakeRadioactive iodine uptake (RAIU) tests thyroid function. It measures how much radioactive iodine is taken up by your thyroid gland in a certain time...ImageRead Article Now Book Mark Article ScanA thyroid scan uses a radioactive iodine tracer to examine the structure and function of the thyroid gland. This test is often done together with a ...ImageRead Article Now Book Mark Article This disease may also affect the following test results:Orbit CT scan or ultrasound Orbit CT scanA computed tomography (CT) scan of the orbit is an imaging method. It uses x-rays to create detailed pictures of the eye sockets (orbits), eyes and ...ImageRead Article Now Book Mark Article Thyroid stimulating immunoglobulin (TSI) TSITSI stands for thyroid stimulating immunoglobulin. TSIs are antibodies that tell the thyroid gland to become more active and release excess amounts ...ImageRead Article Now Book Mark Article Thyroid peroxidase (TPO) antibody Anti-TSH receptor antibody (TRAb) Treatment Treatment is aimed at controlling your overactive thyroid. You may receive one or more types of treatment.Beta-blocker medicines may help treat:Rapid heart rate Sweating AnxietyThey may be given until the hyperthyroidism is controlled.Antithyroid medicines:Block or change how the thyroid gland uses iodine May be used to control the overactive thyroid gland before surgery or radioiodine therapy May be used as a long-term treatmentRadioactive iodine is given by mouth. It then concentrates in the overactive thyroid tissue and causes damage.Surgery may be done to remove the thyroid.If you have had radioactive iodine treatment or surgery, you will need to take replacement thyroid hormones for the rest of your life. This is because these treatments destroy or remove the gland.TREATMENT OF THE EYESSome of the eye problems related to Graves disease often improve after treatment with medicines (including selenium), radiation, or surgery. Radioiodine therapy can sometimes make eye problems worse. Eye problems are worse in people who smoke, even after the hyperthyroidism is treated.Sometimes, prednisone is needed to reduce eye irritation and swelling. Prednisone is a steroid medicine that suppresses the immune system. Other treatments to suppress the immune system may be needed. Ask your provider if these would help you.Sunglasses, cool compresses, and eye drops may reduce eye irritation. In rare cases, surgery or radiation therapy (different from radioactive iodine) may be needed to prevent further damage to the eye and loss of vision. Outlook (Prognosis) Graves disease often responds well to treatment. Thyroid surgery or radioactive iodine often will cause an underactive thyroid (hypothyroidism). Without getting the correct dosage of thyroid hormone replacement, hypothyroidism can lead to:Depression DepressionDepression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...ImageRead Article Now Book Mark Article Mental and physical sluggishness Weight gain Dry skin Constipation Cold intolerance Cold intoleranceCold intolerance is an abnormal sensitivity to a cold environment or cold temperatures.Read Article Now Book Mark Article Abnormal menstrual periods in women When to Contact a Medical Professional Contact your provider if you have symptoms of Graves disease or your eye problems or other symptoms get worse or do not improve with treatment.Go to the emergency room or call 911 or the local emergency number if you have symptoms of hyperthyroidism with: Decrease in consciousness Fever Rapid, irregular heartbeat Sudden shortness of breathOpen ReferencesReferencesHollenberg A, Wiersinga WM. Hyperthyroid disorders. In: Melmed S, Auchus RJ, Golfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 12.Pearce EN, Hollenberg AN. Thyroid. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 207.Smith JR, Wassner AJ. Thyrotoxicosis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 584.Weetman AP, Kahaly GJ. Graves disease. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 71.