Basedow’s disease has three representative symptoms known as the Merseburg triad. Although some patients suffer from all three symptoms, others may have only one or two. The symptoms are:
Goiter is a condition in which the thyroid swells. Most patients with Basedow’s disease have “diffuse goiter,” in which the entire thyroid is enlarged. Others may have differences in the swelling on the right and left sides of the thyroid. Finally, there are even patients who have barely detectable swelling.
Exophthalmos is characterized by the eyes bulging or protruding from their sockets. Exophthalmos and other symptoms that appear in the eyes due to abnormal thyroid functioning (thyroid-associated ophthalmopathy) are characteristic of Basedow’s disease. Eye symptoms also include “eyelid swelling” (swelling of the upper eyelid), “lid retraction” in which the eyelid remains open, and “diplopia” (double vision). However, not all Basedow’s disease patients suffer from these symptoms.
Thyroid hormones increase the body’s metabolism. When thyroid hormones are in excess, metabolism is abnormally high, causing symptoms such as hyperhidrosis (excessive sweating), sensitivity to heat, increased appetite, and weight loss. In addition, organs may be overstimulated, causing tachycardia (racing heart) and bowel movement abnormalities such as loose stool, diarrhea, and frequent bowel movements. Trembling of the limbs and fatigue are also common symptoms. Irritability, insomnia, and poor concentration may reduce work efficiency in adults and hurt academic achievement in children.
Figure 1 lists pretreatment symptom frequencies for Basedow’s disease patients at our hospital.
Basedow’s disease has a variety of symptoms with large individual differences in their appearance. As shown in Figures 2-1 and 2-2, different age groups show different patterns of symptoms. Swelling of the thyroid gland is common in young patients, but relatively rare in elderly patients. On the other hand, weight loss is common in elderly patients, while many young patients have increased appetite and weight gain.