Graves’ disease is an autoimmune condition that affects the thyroid gland, causing an overproduction of thyroid hormones. The treatment is relatively simple, but without it, the disease can have serious effects.

Graves’ disease is an autoimmune condition. This means that the body’s immune system mistakes healthy cells for foreign invasive bodies and attacks them. Graves’ disease causes an overactive thyroid, an issue also called hyperthyroidism.

The thyroid is a small gland in the neck that produces thyroid hormones, which regulate how the body uses energy. Graves’ disease causes the immune system to attack the thyroid, leading to excess thyroid hormone production.

A number of conditions can cause hyperthyroidism, but Graves’ disease is the most common cause in the United States, affecting around 1 in 200 people. The disease is more common among females and people between the ages of 30 and 50.

Graves’ disease takes its name from Sir Robert Graves, an Irish doctor who first described the condition around 150 years ago.

The overproduction of thyroid hormones can have a variety of effects on the body.

Symptoms can include:

  • intolerance to heat
  • unexplained weight loss
  • nervousness
  • sweating
  • hand tremors
  • difficulty sleeping
  • tiredness or weakness
  • irritability
  • frequent bowel movements or diarrhea
  • a goiter, which is an enlarged thyroid gland and may make the neck look swollen
  • an irregular or rapid heartbeat

In rare cases, Graves’ disease can lead to Graves’ dermopathy, which causes thick, flushed skin on the shins.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) explains that while the causes are still unclear, the disease may stem from a combination of genes and external triggers, such as viral infections. People are more likely to develop Graves’ disease if they have a family history of the condition.

Having another autoimmune condition may also increase the risk of Graves’ disease. Some of these conditions include:

Effects of Graves’ disease on the body

Graves’ disease affects the thyroid gland, a butterfly-shaped organ at the base of the neck, just above the collarbone. It is an important part of the endocrine, or hormonal, system.

The thyroid gland regulates metabolism by releasing hormones into the bloodstream. Thyroid hormones maintain bone health, brain development, and proper functioning of the heart, muscles, and digestive system.

The pituitary gland, a small gland at the base of the brain, produces thyroid-stimulating hormone (TSH). This tells the thyroid gland how much thyroid hormone to produce, depending on how much the body needs.

In someone with Graves’ disease, the immune system produces thyroid-stimulating immunoglobulin (TSI). TSI is an antibody that acts like TSH but causes the thyroid to produce more thyroid hormone than the body needs. This can affect how the body uses energy.

Learn more about hyperthyroidism here.

There are a variety of treatments for Graves’ disease. The goal is to stop the overproduction of thyroid hormones and relieve the symptoms.

Anti-thyroid medication

These medications work to reduce the amount of hormone that the thyroid makes. This is one of the simplest approaches hyperthyroidism.

The NIDDK reports that a drug called methimazole (Northyx, Tapazole) is one of the most commonly used anti-thyroid medications.

These drugs do not represent a cure, but they can have lasting effects. Thyroid levels may take many weeks or months to come down, however. The treatment may take 12–18 months or longer to work.

As a result, a doctor may also recommend another approach, such as radioiodine therapy or surgery.

Radioiodine therapy

In the U.S., the most common treatment for Graves’ disease is radioiodine therapy.

This involves taking radioactive iodine orally, either in capsule or liquid form. It targets the thyroid gland and destroys the cells that produce thyroid hormone.

This means that most people who have radioiodine therapy go on to develop an underactive thyroid, or hypothyroidism. This is much easier to manage and does not cause as many long-term health issues as hyperthyroidism.

Learn more about iodine here.

Beta-blockers

The American Thyroid Association recommends beta-blockers as an initial treatment for hyperthyroidism.

These medications prevent thyroid hormone from carrying out its usual functions as it circulates in the bloodstream. Once thyroid levels are within a healthy range, people can stop taking beta-blockers.

This can be a quick and temporary way to relieve symptoms such as an increased heartbeat, nervousness, and trembling. It usually starts working within hours.

Surgery

Surgery is a less common treatment for Graves’ disease, but doctors may recommend it for people who are pregnant or have large goiters, or when other treatments have been unsuccessful.

Thyroidectomy is the removal of all or part of the thyroid gland. A surgeon may remove one or both lobes of the gland, and possibly surrounding lymph nodes, depending on the severity of the condition.

If a surgeon only removes part of the thyroid, the remaining portion can take over its functions.

If a surgeon removes the whole thyroid, the body will be unable to produce enough thyroid hormone, a condition called hypothyroidism. To treat this, a doctor will prescribe thyroid hormone pills, which replace the effect of the hormone.

The biggest advantage of surgery is that it may be the quickest, most consistent, and most permanent way to address the issue.

After surgery, a person may have neck pain and a hoarse or weak voice. These may be temporary and result from the breathing tube used during the procedure.

The surgery can leave a scar, and the extent of it may depend on how much of the thyroid is removed.

Graves’ disease can affect the eyes. In this case, the doctor may call the issue Graves’ ophthalmology. The symptoms usually develop within about 6 months of a Graves’ disease diagnosis.

These symptoms can include:

  • inflammation of the whites of the eye
  • redness
  • swollen or retracted eyelids
  • sensitivity to light
  • an irritated or gritty feeling in the eye
  • exophthalmos, which is bulging of the eyes
  • dryness or wateriness
  • sensitivity

Due to increased pressure on the optic nerves, untreated Graves’ ophthalmology can lead to double vision, and in rare cases, loss of vision.

It is still unclear why the disease affects the eyes. The severity of the condition does not correlate with the severity of eye symptoms. Grave’s ophthalmology affects roughly 1 in 3 people with Graves’ disease.

Slightly higher levels of thyroid hormones are usually not a cause for concern in pregnancy. However, it is important to bring down very high thyroid levels before becoming pregnant.

Anyone who is pregnant and has Graves’ disease should discuss which treatment options are safe with a doctor.

A doctor first assesses the symptoms and looks for signs of Graves’ disease, such as an enlarged thyroid. They also check for thyroid issues in a person’s family medical history.

They may then order:

  • a blood test to check for TSI
  • a radioactive iodine uptake test, which measures how much iodine the thyroid gland gathers from the bloodstream
  • a thyroid scan, to show how much iodine is in the thyroid gland

High levels of iodine may indicate Graves’ disease.

Graves’ disease can cause a sensitivity to iodine, the NIDDK explains.

Iodine is in seaweeds, such as kelp and dulse. If a person has Graves’ disease, eating foods rich in iodine or taking iodine supplements may make the symptoms of worse. People should discuss any necessary dietary changes with their doctors.

The NIDDK also recommends speaking with a doctor before taking a multivitamin supplement or using cough medicine, as these can also contain iodine.

Learn about the best diet for hyperthyroidism here.

Graves’ disease usually requires ongoing treatment, unless a person has had successful surgery.

Treatments for the disease are likely to cause hypothyroidism — a lack of thyroid hormones. This, however, is easier to manage, by taking a daily thyroid hormone tablet.

Graves’ disease is an autoimmune condition that causes an overactive thyroid. This refers to having too much thyroid hormone in the body, an issue that is also called hyperthyroidism.

Treatment may include medications to reduce the production of thyroid hormone, radioiodine therapy, or surgery to remove the thyroid.

The treatments may result in low thyroid levels, or hypothyroidism. This is easier to manage than hyperthyroidism, and it involves taking a daily pill.