Graves’ disease is an autoimmune disorder that causes the thyroid gland to become overactive. It is the most common cause of hyperthyroidism (overactive thyroid).
The thyroid is a small butterfly-shaped gland located at the front of your neck. It controls metabolism, heart rate, body temperature and energy levels. When Graves’ disease overstimulates the thyroid, it produces too much thyroid hormone, causing many systems in the body to speed up.
Early diagnosis and treatment can help prevent complications.
Graves’ disease occurs when the immune system mistakenly attacks the thyroid gland. It produces antibodies called thyroid-stimulating immunoglobulins (TSI) that signal the thyroid to release excess thyroid hormone.
Unlike other causes of hyperthyroidism, Graves’ disease is autoimmune. It may also affect the eyes and skin, not just the thyroid.
The exact trigger is not fully understood. Researchers believe it develops from a combination of genetic and environmental factors.
Risk factors include:
Smoking increases the risk of thyroid eye disease in people with Graves’ disease.
Graves’ disease symptoms are caused by excess thyroid hormone and may develop gradually or suddenly.
Common symptoms include:
Graves’ ophthalmopathy, also called thyroid eye disease, affects some people with Graves’ disease.
Symptoms may include:
Eye symptoms may develop before, during or after thyroid symptoms. Smoking significantly increases the risk and severity of eye complications.
A rare complication called pretibial myxedema causes thickened, reddish or discolored skin, usually on the shins or tops of the feet.
Diagnosis involves a combination of medical history, physical exam and laboratory testing.
You may be referred to an endocrinologist for specialized care.
Low TSH with elevated T3 and T4 suggests hyperthyroidism. Positive thyroid antibodies help confirm Graves’ disease.
This test measures how much iodine your thyroid absorbs. High uptake supports a diagnosis of Graves’ disease.
Ultrasound may be used to evaluate gland size and blood flow.
Treatment focuses on reducing excess thyroid hormone and managing symptoms.
Drugs such as methimazole reduce thyroid hormone production. Beta blockers may help relieve symptoms like rapid heart rate or tremors.
RAI gradually shrinks the thyroid and lowers hormone production. It often results in hypothyroidism, requiring lifelong thyroid hormone replacement.
RAI is not recommended during pregnancy or breastfeeding and may temporarily worsen eye symptoms.
Removing part or all of the thyroid may be recommended for large goiters, severe eye disease or when other treatments are not appropriate.
After surgery or RAI, lifelong thyroid hormone replacement therapy is usually required.
With proper treatment, most people live healthy lives.
If untreated, Graves’ disease can lead to:
Symptoms of thyroid storm include high fever, confusion, vomiting, severe rapid heart rate and low blood pressure. Call 911 if these symptoms occur.
Some people experience remission after treatment with anti-thyroid medication. However, Graves’ disease is typically a lifelong autoimmune condition that requires ongoing monitoring.
Regular follow-up with your health care provider helps maintain stable thyroid hormone levels.
You can help manage your condition by:
Contact a provider if you experience:
Early treatment can prevent complications and protect long-term health.
Our endocrinology specialists provide comprehensive diagnosis, treatment and long-term management for Graves’ disease, including coordination of care for thyroid eye disease when needed.
Schedule an appointment to discuss your thyroid health and create a personalized treatment plan.
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