Liv Hospital health content is written by a content specialist, verified by an independent expert and medically approved by a physician in the relevant field.
- Şevval TatlıpınarWriter
- Lamiya GurbanovaFact-checker
- Prof. MD. Berçem AyçiçekMedical reviewer
Şevval Tatlıpınar is a versatile Content Writer with three years of professional…
View author profile →
Dr. Lamiya Gurbanova is a physician who completed her specialization training in…
View profile →
Approved this content for clinical accuracy in their specialty.
View doctor profile →We review our content at regular intervals and update it whenever new research or a change in clinical guidelines requires it.
Overview
What Is Graves Disease?
Graves disease is an autoimmune condition that causes the thyroid gland to become overactive. The immune system mistakenly stimulates the thyroid, leading it to make too much thyroid hormone. This can speed up many body processes and cause symptoms of hyperthyroidism. It can affect people of any age, but it is more common in women and often begins during adulthood; patterns vary from person to person.
Symptoms
Graves Disease Symptoms
- Heat intolerance
- Increased sweating
- Unintentional weight loss
- Rapid heartbeat
- Irregular heartbeat
- Hand tremor
- Anxiety or irritability
- Fatigue
- Frequent bowel movements
- Menstrual changes
- Enlarged thyroid gland (goiter)
- Bulging eyes (proptosis)
- Eye pressure or discomfort
- Dry, gritty, or light-sensitive eyes
IMPORTANT
Symptoms can vary
Graves disease symptoms may develop gradually or appear more suddenly, and not everyone has the same pattern. Eye symptoms can occur along with thyroid symptoms or independently of them, so persistent or worsening changes should be assessed by a healthcare professional.
Causes
What Causes Graves Disease?
In Graves disease, the immune system makes thyroid-stimulating antibodies, commonly called thyroid-stimulating immunoglobulins (TSI) or TSH receptor antibodies (TRAb). These antibodies attach to thyroid cells and activate them in a way that resembles the normal thyroid-stimulating hormone signal, increasing thyroid hormone production. The exact reason this immune response begins is not fully known.
Risk Factors
Risk Factors for Graves Disease
| Risk factor category | Examples and context |
|---|---|
| Non-modifiable or difficult-to-change | Family history of Graves disease or other autoimmune disease; female sex; and age, with many cases beginning during adulthood. |
| Personal or family health history | Having an autoimmune condition, or having close relatives with autoimmune thyroid disease, may increase susceptibility. |
| Pregnancy-related factors | Pregnancy or recent childbirth can be associated with changes in immune activity that may affect thyroid disease risk. |
| Potentially modifiable | Smoking is linked particularly with thyroid eye disease and can worsen eye involvement; stopping smoking is beneficial. |
| Context-dependent exposure | High iodine exposure from certain medicines, supplements, or medical products may affect thyroid function in susceptible people. |
Having one or more risk factors does not mean someone will develop Graves disease. People without recognized risk factors can still be affected, and risk factors cannot predict exactly who will develop the condition.
Complications
Complications of Graves Disease
- Thyroid eye disease can cause swelling, dryness, pain, light sensitivity, or changes in the appearance and movement of the eyes.
- Severe thyroid eye disease can threaten vision if the optic nerve or the surface of the eye is affected.
- An irregular heart rhythm, including atrial fibrillation, can develop when excess thyroid hormone affects the heart.
- Heart failure can occur when untreated hyperthyroidism places prolonged strain on the heart.
- Weakened bones or osteoporosis may develop when excess thyroid hormone continues over time.
- Thyroid storm is a rare, life-threatening worsening of hyperthyroidism that can cause fever, confusion, and a very fast heartbeat.
- During pregnancy, poorly controlled disease can increase risks for pregnancy complications and problems affecting the newborn.
Seek urgent care
Know the warning signs
Severe chest symptoms, confusion, a very high fever, or a markedly fast heartbeat require emergency care. These symptoms may signal a serious complication of uncontrolled thyroid disease.
Diagnosis
How Graves Disease Is Diagnosed
Clinicians review symptoms and medical history and examine the thyroid, eyes, and heart rate. Blood tests commonly measure thyroid-stimulating hormone (TSH) and thyroid hormones such as free T4 and T3. The results help show whether the thyroid is overactive and guide further testing.
ANTIBODY TESTS
TRAb or TSI testing looks for antibodies that stimulate the thyroid and can support a diagnosis of Graves disease.
THYROID IMAGING
A radioactive iodine uptake test or thyroid scan may show how actively the thyroid makes hormone and help distinguish Graves disease from other causes of hyperthyroidism.
ULTRASOUND
Thyroid ultrasound may be used in selected cases to assess the gland, especially when other imaging is unsuitable or a structural problem also needs evaluation.
EYE EXAMINATION
An eye examination can assess suspected thyroid eye disease, including eye movement, surface changes, pressure, and possible effects on vision.
Treatment & Management
Treatment and Management of Graves Disease
| Treatment | Role and considerations |
|---|---|
| Antithyroid drugs | Reduce thyroid hormone production and may be used to control hyperthyroidism or seek remission. They require follow-up for thyroid levels and possible side effects, and relapse can occur after treatment stops. |
| Beta blockers | Help relieve symptoms such as a fast heartbeat, tremor, and shakiness while thyroid treatment takes effect. They control symptoms but do not stop antibody-driven thyroid hormone production. |
| Radioactive iodine | Gradually reduces thyroid activity and can provide definitive treatment. It is not used in pregnancy and may worsen some thyroid eye disease; many people need lifelong thyroid hormone replacement afterward. |
| Thyroid surgery | Removes all or most of the thyroid and may be considered with a large goiter, certain nodules, pregnancy-related circumstances, medication limitations, or significant eye disease. Lifelong thyroid hormone replacement is generally needed after total removal. |
Thyroid Eye Disease and Supportive Care
Stopping smoking is especially important because smoking can worsen thyroid eye disease. Lubricating eye drops, sunglasses, and other eye protection may ease dryness and light sensitivity. Moderate or severe eye disease may require evaluation by an eye specialist, and treatment choices should be coordinated with an endocrinologist and eye specialist when appropriate.
Outlook and Prognosis
Outlook and Prognosis
Most people can control Graves disease with appropriate treatment, but the course varies. Some people enter remission after a period of treatment, while others need long-term medication or definitive treatment with radioactive iodine or surgery. Ongoing follow-up is important because thyroid levels and eye symptoms may change over time.
- Regular thyroid blood tests help monitor hormone levels and guide ongoing treatment.
- An underactive thyroid may occur after radioactive iodine or surgery and can require lifelong thyroid hormone replacement.
- Hyperthyroidism can return after remission, so new or recurring symptoms should be reported.
- Thyroid eye disease may persist or progress even when thyroid hormone levels are controlled.
- Keeping scheduled follow-up visits helps detect recurrence, treatment effects, and complications early.
When Should You See a Doctor
When Should You See a Doctor?
Get urgent help
Recognize emergency symptoms
Seek emergency care for severe shortness of breath, chest pain, fainting, confusion, very high fever, severe vomiting, or a very fast or irregular heartbeat. Sudden vision loss or severe eye pain also requires urgent eye assessment.
Tests & Procedure
1 topic
Graves Disease
Tsh Blood Test
Symptoms
2 topics
Graves Disease
Excessive Sweating
Graves Disease
Unexplained Weight Loss
