Graves' Dermopathy/ Pretibial Myxedema -- This is an unusual symptom seen in some Graves' patients that features waxy, reddish-brown lesions on the shins and lower legs skin (and less often the extremities, face or trunk) that are itchy and inflamed. These lesions heal into rough patches.
Changes to Hair / Nails / Hands -- Excessive hair loss from the head and body is a common symptom. Other signs include thinner and finer hair, nails that easily break. Thyroid acropachy, where fingertips and toes swell and become wider, even clubbed, and onycholysis/Plummer's nails, where the underlying nail bed separates away from the skin, are also symptoms of Graves' and hyperthyroidism.
Eye Problems -- Even in patients who don't have Graves' Ophthalmopathy, there can be eye-related symptoms, including bulging of the eyeballs, dry eyes, achiness or pain behind the eyes, redness in the eyes, puffiness, and a wide-eyed look.
Thinking/Cognition Problems -- Some Graves' and hyperthyroidism patients have difficult concentrating or making decisions, memory problems, and racing thoughts.
Mood Problems -- Most patients with Graves' disease, hyperthyroidism experience some changes to mood and feelings, including depression, mood swings, uncontrollable anger, and irrational anger.
Panic and Anxiety -- Anxiety is a very common hyperthyroidism symptom, including restlessness, nervousness, and even panic attacks. In rare cases, mania, psychosis, or delirium can be hyperthyroidism symptoms.
Reflex/Movement Issues -- Some people with hyperthyroidism have fast reflexes, startle easily, and jumpy, and have tremors. They may be always moving, jiggling, tapping a foot, etc.
Sleep Problems -- Insomnia, or difficulty going back to sleep after waking, are common hyperthyroidism symptoms.
Especially in Men -- Men can experience a low sex drive, fertility problems, and gynecomastia, an enlargement or tenderness in the breasts.
Especially in Women -- In women, hyperthyroidism can cause infertility, miscarriage, changes to sex drive, worsening premenstrual syndrome, erratic or even nonexistent menstrual periods.
Especially in Newborns/Babies -- Newborns who are hyperthyroid are more likely to be premature, and have a low birthweight. They may have a yellowish cast to the skin, a visible goiter or enlarged neck, and prominent eyes. These babies may also have an elevated heart rate and body temperature. In terms of temperament, these babies may be irritable, restless, hyperactive, and appear to be anxious or unusually alert. They may eat but suffer from frequent diarrhea and vomiting, and may fail to gain weight.
Especially in Children -- Children with hyperthyroidism are likely to have a goiter. They may also have increased appetite and/or weight loss, weakness, school problems, hyperactivity, emotional outbursts, and temper tantrums.
Especially in Teenagers -- In teenagers, a dramatic increase in appetite, or unusual weight loss, may be seen. They may have sports performance problems, and delayed puberty.
Especially in the Elderly / Seniors -- Older people may have more frequent falls, tremors, atrial fibrillation, or dementia. Some older people have what's known as "apathetic hyperthyroidism" -- which has symptoms not typically associated with hyperthyroidism, including appearing depressed, lacking in energy, confused, forgetful, and constipated -- without weight loss.
Graves' OphthalmopathyGraves' Ophthalmopathy is an inflammatory autoimmune eye disorder that, while separate from Graves' disease that affects the thyroid, is often seen in conjunction with it. Graves' Ophthalmopathy is also known by a variety of other names, including thyroid eye disease (TED), thyroid associated ophthalmopathy (TAO), thyroid associated orbitopathy, orbital dystrophy (OD), dsythyroid orbitopathy, thyroid ophthalmopathy, exophthalmos, immune exophthalmos, Grave's orbitopathy, and Graves' eye disease.
For Graves' disease patients who also have Graves ophthalmopathy, in addition to bulging of the eyes, one of the more common eye-related symptoms is "lid lag" -- where the upper eyelid doesn't smoothly follow along when you look down. Other symptoms can include pain or itchiness, blurred vision, reduced color or brightness in vision, double vision, poor night vision, light sensitivity, and "floaters."
Thyroid StormA very small percentage of patients with hyperthyroidism develop a life-threatening condition known as thyroid storm. During a thyroid storm, the heart rate, blood pressure and body temperature can become uncontrollably high. Symptoms can include an extremely high fever (up to 106), a heart rate as high as 200 beats per minute, palpitations, chest pain, shortness of breath, high blood pressure, confusion, delirium, psychosis, stupor, fatigue, and other symptoms. Whenever thyroid storm is suspected, the patient must go immediately on an emergency basis to the hospital, as this is a life-threatening condition that can develop and worsen quickly, and requires treatment within hours to avoid fatal complications such as stroke or heart attack.