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Your Guide to Graves' Disease

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Graves’ Disease: Symptoms, Triggers, and Outlook

Medically Reviewed By Marina Basina, M.D.

Graves’ disease is when the immune system attacks the thyroid gland. This can lead to a condition called hyperthyroidism, causing symptoms such as an irregular heartbeat, sweating, and more. Graves’ disease is considered an autoimmune disease as it occurs when the immune system attacks the body. Treatment with options such as medication and surgery can improve your symptoms and reduce related hyperthyroidism.

This article explains Graves’ disease, including its symptoms, causes, and when to see a doctor. It also discusses possible complications, treatment, and outlook of the condition, as well as some frequently asked questions.


A medical illustration depicting the possible symptoms of Graves' disease.
Illustrated by Jason Hoffman

Graves’ disease can cause damage to the thyroid gland, leading to hyperthyroidism. According to a 2022 overview Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , Graves’ disease is the most common cause of hyperthyroidism.

Hyperthyroidism, or overactive thyroid, refers to when the thyroid gland makes too much Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source thyroid hormone.

Thyroid hormones contribute to many processes in the body. Because of this, hyperthyroidism can lead to a range of symptoms, such as:

  • fast or irregular heartbeat
  • unexplained weight loss, even with an increase in appetite
  • fatigue
  • difficulty sleeping
  • sweating or sensitivity to heat
  • shaky hands
  • muscle weakness
  • nervousness or irritability
  • more frequent bowel movements

The thyroid is a small butterfly-shaped organ that sits in the front of the neck. Graves’ disease may cause the thyroid gland to enlarge, causing a bulge known as a goiter around the lower neck.

Graves’ disease may also cause an eye condition called Graves’ ophthalmopathy (GO). This can lead to symptoms such as:

  • eyes that appear to bulge
  • eye pain or pressure
  • gritty or irritated eyes
  • puffy eyes
  • sensitivity to light
  • blurry vision
  • double vision

In rare cases, someone with Graves’ disease may develop a skin condition called Graves’ dermopathy. This can cause discolored, rough, and thick skin to develop. Graves’ dermopathy frequently develops on the shins but can also develop elsewhere.

When to see a doctor

Contact your doctor promptly if you experience any symptoms of Graves’ disease. You should also contact your doctor for any other symptoms of illness that do not improve.

Some symptoms or complications may require more urgent medical care. They may indicate another serious medical condition or carry a risk of longer-term damage.

Seek immediate medical help for any of the following symptoms:

  • fast or irregular heartbeat that persists or doesn’t improve with rest
  • blurry vision
  • sudden eye symptoms, such as sudden eye bulging
  • symptoms that feel severe, such as severe muscle weakness

Causes and triggers

Graves’ disease develops when the immune system produces an antibody known as thyroid-stimulating immunoglobulin (TSI). TSI can then bind Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source to a hormone known as thyroid-stimulating hormone (TSH). This causes the thyroid gland to make thyroid hormone in higher amounts.

Clinicians still aren’t completely sure why some people develop Graves’ disease and others don’t. Research suggests that genetic and environmental factors may contribute to its development. For example, certain environmental factors may trigger susceptible genes to produce immune responses related to TSI production. This can lead to Graves’ disease.

Factors that may trigger Graves’ disease include:

  • pregnancy and the postpartum period
  • infections
  • emotional stress
  • smoking
  • treatment with or misuse of the medication interferon alfa (Intron, Roferon-A)
  • excess iodine intake, from products such as Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :
    • supplements
    • iodized salt
    • iodized drinking water or milk
    • some seaweeds


Your doctor will start the diagnostic process by asking about your symptoms and medical history. It can be helpful to inform your doctor whether any biological family members have had Graves’ disease.

Your doctor may then order testing to confirm a diagnosis. This can also help to rule out other conditions that can cause hyperthyroidism. Tests may include Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

  • Thyroid function tests: These tests involve taking a blood sample for laboratory exams.
  • TSH receptor antibody tests: These also use a blood sample to measure thyroid antibody levels. This can help identify Graves’ disease.
  • Radioactive iodine uptake scan: This test involves taking radioactive iodine medication. A scan then monitors how much of the iodine accumulates in the thyroid. A high and widespread buildup of iodine in the gland can indicate Graves’ disease.
  • Thyroid ultrasonogram: This uses an imaging scan to examine the structure of the thyroid.
  • CT or MRI scans: These additional imaging scans can be used to identify Graves’ ophthalmopathy (GO).


Treating Graves’ disease typically involves managing symptoms and addressing any complications. Treatment methods can include:

  • Medication: Medications such as beta-blockers, calcium channel blockers, and antithyroid medications may help relieve symptoms and reduce thyroid hormone levels.
  • Radioiodine therapy: This involves taking radioactive iodine medications orally. The iodine then destroys cells of the thyroid gland that are producing excess thyroid hormones.
  • Thyroid surgery: This removes part or most of the thyroid and can help return thyroid levels to normal. However, this treatment is less common.

Examples of medications to treat Graves’ disease include:

  • beta-blockers, such as atenolol (Tenormin) and propranolol (Hemangeol, Inderal, Innopran)
  • calcium channel blockers, such as diltiazem (Cardizem, Dilacor, Matzim) and verapamil (Calan, Verelan)
  • antithyroid medications, such as methimazole (Northyx, Tapazole) and propylthiouracil (PTU), especially during pregnancy
  • radioactive iodine, such as sodium iodide (Hicon)

Treatment for hyperthyroidism can lead to hypothyroidism. This is when the thyroid gland produces too little thyroid hormone. However, managing hypothyroidism with daily medication may lead to fewer complications than untreated hyperthyroidism.

Some people may need to take hypothyroidism medication for the rest of their life. They may also need regular check-ups to evaluate their hormone levels.

Treatment to address complications such as GO can include:

  • steroid medication
  • surgery to improve eye symptoms, such as impaired vision or bulging eyes
  • rarely, radiation therapy


Certain lifestyle changes and self-care techniques may improve Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source symptoms and support health for people with Graves’ disease. These can include:

  • managing stress, such as with counseling or meditation
  • getting regular exercise
  • working with a doctor or dietitian to maintain a healthy diet
  • avoiding smoking
  • using over-the-counter (OTC) lotions your doctor or pharmacist recommends for Graves’ dermopathy

Self-care techniques to manage symptoms of GO can include:

  • applying a clean, cool compresses to the eyes
  • wearing sunglasses
  • using over-the-counter eye drops with advice from a doctor or pharmacist


Graves’ disease can lead to complications and have further effects on your health, such as Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

  • accelerated hyperthyroidism
  • Graves’ ophthalmopathy, which causes vision loss, in rare Trusted Source National Eye Institute Governmental authority Go to source cases
  • agranulocytosis, a condition where levels of white blood cells known as granulocytes are too low
  • heart conditions, such as atrial flutter, atrial fibrillation, and heart failure

The outlook for Graves’ disease can vary per person. Effective and early treatment can help improve your outlook. It’s also possible to experience remission with Graves’ disease. This is when you no longer experience symptoms of illness. In fact, a 2019 review suggests that 27% Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of people with Graves’ disease were in remission after a 20-year follow-up.

However, some people experience a return of the condition or other complications, such as continued hyperthyroidism. Due to this, some individuals may require medical treatment or monitoring for the rest of their lives.

Contact your doctor for individualized advice about your outlook and treatment.


Graves’ disease is an autoimmune condition in which the immune system damages the thyroid gland. This can cause a range of symptoms, including an irregular heartbeat, sensitivity to heat, and eye irritation.

Treatment with therapies such as medication and surgery may help alleviate symptoms or cause remission. However, some people may require ongoing care.

Contact your doctor promptly if you notice any symptoms of Graves’ disease. They can provide individualized advice regarding your treatment and outlook.

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Medical Reviewer: Marina Basina, M.D.
Last Review Date: 2023 Apr 13
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