Double vision linked to Graves’ disease

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DEAR DR. GOTT: Is Graves’ disease curable? I have hyperthyroidism and double vision I’m told is from the disease. What can I do?

DEAR READER: Graves’ disease is not curable, but it’s completely treatable. This type of hyperthyroidism occurs when the immune system mistakenly attacks the thyroid gland, causing it to produce an excess of a hormone known as thyroxine. The immune system cannot be prevented from attacking the thyroid gland, but fortunately there are several treatments available to lower the production of thyroxine and ease the symptoms.

Signs of the disorder may include a goiter (enlarged thyroid gland), hand or finger tremor, irregular heartbeats, difficulty sleeping, anxiety and weight loss. The eyes may show signs of Graves’ ophthalmopathy, which most notably causes them to protrude beyond their protective orbits. The lids swell, the eyes might become red and, infrequently, double or blurred vision may be present.

Other serious complications from Graves’ involve the heart and include congestive heart failure (CHF) and atrial fibrillation. CHF occurs when the heart is incapable of circulating sufficient blood to meet the needs of the body. Atrial fibrillation is an abnormality of the rhythm of the heart. Then there’s osteoporosis from untreated Graves’ because excessive amounts of thyroid hormone leaches calcium from the bones, causing them to become brittle.

Treatment may include drugs known as beta blockers, radioactive iodine or anti-thyroid medication to prevent the thyroid from producing excessive hormones. Control with radioactive iodine will cause the gland to shrink, symptoms will be reduced, and the gland may ultimately reverse to a state of hypothyroidism (too little thyroid hormone) and require supplemental thyroid hormones. This treatment option may worsen any symptoms of Graves’ ophthalmopathy, so this may not be an option for you. The use of anti-thyroid medication for a year or two may lead to long-term remission of the disease; however, relapse can occur.

Make an appointment with an endocrinologist if you haven’t already done so. Visit a nutritionist who can review your diet and recommend specific foods to combat any weakness or fatigue. Plan to have laboratory testing at least on an annual basis. By taking care of your general health, you should be able to lead a long, normal life.

Readers who would like related information can order my Health Report “The Thyroid Gland” by sending a self-addressed, stamped number No. 10 envelope and a $2 U.S. check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 060349-0433. Be sure to mention the title when writing, or print out an order form from my website’s direct link:

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