Launching September 2027

Graves’ Disease

Graves’ Disease At A Glance

  • Graves’ disease is an autoimmune disorder and the most common cause of hyperthyroidism, or an overactive thyroid.
  • It causes the immune system to produce antibodies that overstimulate the thyroid gland, leading to excessive thyroid hormone production.
  • Common symptoms include weight loss, rapid or irregular heartbeat, anxiety, tremors, heat intolerance, sweating, fatigue, and an enlarged thyroid.
  • Some people develop Graves’ eye disease, which can cause bulging eyes, dryness, irritation, double vision, or other vision changes.
  • Diagnosis typically uses thyroid blood tests and antibody testing, with imaging or eye evaluation when needed.
  • Treatment may include anti-thyroid medication, radioactive iodine therapy, beta-blockers, surgery, and treatment for Graves’ eye disease.

Table of Contents

Table of Contents

What Is Graves’ Disease?

Graves’ disease is an autoimmune disorder and the most common cause of hyperthyroidism (overactive thyroid). In Graves’ disease, the body’s immune system mistakenly produces antibodies that stimulate the thyroid gland to make too much thyroid hormone.

Excess thyroid hormone causes the body’s metabolism to speed up, leading to symptoms such as weight loss, rapid heartbeat, anxiety, tremors, and heat intolerance. Some people also develop Graves’ eye disease (Graves’ ophthalmopathy), which can cause eye irritation, bulging eyes, double vision, or vision changes.

Although there is no cure for Graves’ disease, it can usually be managed successfully with medications, radioactive iodine therapy, or surgery.

Learn More

Graves’ Disease – NIH MedlinePlus
https://medlineplus.gov/gravesdisease.html

Provides easy-to-understand information about Graves’ disease, including symptoms, diagnosis, treatment, and long-term management.

Graves’ Disease – American Thyroid Association
https://www.thyroid.org/graves-disease/

Explains what Graves’ disease is, common symptoms, causes, diagnosis, and treatment options.

How Common Is Graves’ Disease?

Graves’ disease is the most common cause of hyperthyroidism in the United States. It affects millions of people worldwide and is much more common in women than men. Although it can occur at any age, it is most often diagnosed between the ages of 20 and 50.

Learn More

American Thyroid Association – Graves’ Disease
https://www.thyroid.org/graves-disease/

Provides information about who is most likely to develop Graves’ disease and common risk factors.

What Symptoms Might You Notice?

Symptoms may develop gradually or appear more suddenly.

Common symptoms may include:

  • Unexplained weight loss
  • Rapid or irregular heartbeat
  • Feeling hot or excessive sweating
  • Nervousness or anxiety
  • Tremors (shaking hands)
  • Difficulty sleeping
  • Increased appetite
  • Frequent bowel movements
  • Muscle weakness
  • Fatigue
  • Irritability
  • Fine, thinning hair
  • Enlarged thyroid gland (goiter)

Some people may also develop Graves’ eye disease, which can cause:

  • Bulging eyes
  • Eye pain or pressure
  • Dry, gritty, or irritated eyes
  • Sensitivity to light
  • Double vision
  • Vision changes

How Is Graves’ Disease Diagnosed?

Your healthcare provider will review your symptoms, perform a physical examination, and order blood tests to evaluate thyroid hormone levels. Additional testing helps confirm Graves’ disease and determine the cause of hyperthyroidism.

Learn More

Graves’ Disease – NIH MedlinePlus
https://medlineplus.gov/gravesdisease.html

Explains how Graves’ disease is diagnosed and monitored.

Graves’ Disease infographic – click to enlarge

What Causes Graves’ Disease?

Graves’ disease develops when the immune system produces antibodies called thyroid-stimulating immunoglobulins (TSI) that stimulate the thyroid gland to produce excessive amounts of thyroid hormone.

Common risk factors include:

  • Family history of thyroid disease
  • Female sex
  • Other autoimmune diseases
  • Smoking (especially increases the risk of Graves’ eye disease)
  • Emotional or physical stress
  • Pregnancy (particularly after childbirth)

Learn More

Graves’ Disease – NIH MedlinePlus
https://medlineplus.gov/gravesdisease.html

Learn about the causes and risk factors associated with Graves’ disease.

What Can Make Graves’ Disease Worse?

Several factors may worsen symptoms or interfere with treatment.

Common factors include:

  • Missing prescribed medications
  • Smoking
  • Excess iodine intake
  • Certain medications
  • Poorly controlled thyroid hormone levels
  • Uncontrolled stress

Learn More

American Thyroid Association
https://www.thyroid.org/

Provides practical guidance on managing Graves’ disease and reducing complications.

Prevention

Graves’ disease cannot currently be prevented because it is an autoimmune disease. However, early diagnosis and treatment can reduce the risk of serious complications.

Helpful prevention tips include:

  • Take medications exactly as prescribed.
  • Attend regular healthcare appointments.
  • Have routine thyroid blood tests as recommended.
  • Do not smoke or vape.
  • Report new or worsening symptoms promptly.
  • Follow your healthcare provider’s recommendations for eye care if you have Graves’ eye disease.
  • Discuss iodine-containing supplements or medications with your healthcare provider before taking them.

Learn More

American Thyroid Association
https://www.thyroid.org/

Provides practical information about Graves’ disease, medication management, and long-term care.

Learn More About Graves’ Disease

The following video content is provided to help you better understand this condition. These resources are intended for educational purposes and should not replace personalized medical advice from your healthcare provider.

Labs

Laboratory testing is essential for diagnosing and monitoring Graves’ disease.

Common laboratory tests may include:

  • Thyroid-Stimulating Hormone (TSH): Usually very low.
  • Free T4 (Free Thyroxine): Usually elevated.
  • Free T3 (Triiodothyronine): Often elevated.
  • Thyroid-Stimulating Immunoglobulin (TSI): Helps confirm Graves’ disease.
  • Thyrotropin Receptor Antibody (TRAb): Another antibody test commonly used to diagnose Graves’ disease.
  • Complete Blood Count (CBC): May be checked before starting anti-thyroid medications.
  • Liver Function Tests: May be monitored while taking anti-thyroid medications.

Learn More

TSH Test – NIH MedlinePlus
https://medlineplus.gov/lab-tests/tsh-thyroid-stimulating-hormone-test/

Explains how thyroid blood tests help diagnose Graves’ disease.

Diagnostics

Additional testing may help determine the cause of hyperthyroidism and evaluate thyroid structure.

Common diagnostic tests include:

  • Radioactive Iodine Uptake (RAIU) Test: Measures how much iodine the thyroid absorbs and helps confirm Graves’ disease.
  • Thyroid Scan: Shows how thyroid tissue is functioning.
  • Thyroid Ultrasound: Evaluates thyroid enlargement or nodules.
  • Electrocardiogram (ECG/EKG): Evaluates rapid or irregular heart rhythms caused by excess thyroid hormone.
  • Eye Examination: May be recommended if Graves’ eye disease is suspected.

Learn More

American Thyroid Association – Thyroid Function Tests
https://www.thyroid.org/thyroid-function-tests/

Provides information about thyroid blood tests, imaging studies, and diagnostic testing.

Treatment & Management

Treatment Options

Treatment focuses on lowering thyroid hormone levels, relieving symptoms, and preventing long-term complications.

Treatment options may include:

  • Anti-thyroid medications
  • Radioactive iodine therapy
  • Beta-blockers for symptom relief
  • Thyroid surgery (thyroidectomy)
  • Treatment for Graves’ eye disease when present
  • Regular laboratory monitoring

Learn More

Graves’ Disease – American Thyroid Association
https://www.thyroid.org/graves-disease/

Provides information about treatment options and long-term management of Graves’ disease.

Lifestyle Changes

Healthy lifestyle habits can help support your treatment plan and improve overall well-being.

Helpful lifestyle changes include:

  • Take medications exactly as prescribed.
  • Attend regular healthcare appointments.
  • Avoid smoking.
  • Eat a balanced diet.
  • Stay physically active as tolerated.
  • Get enough sleep.
  • Manage stress.
  • Protect your eyes if you have Graves’ eye disease by using lubricating eye drops if recommended and wearing sunglasses outdoors.
  • Report new or worsening symptoms promptly.

Learn More

American Thyroid Association
https://www.thyroid.org/

Provides practical guidance for living well with Graves’ disease.

Medications

Several medications are available to treat Graves’ disease and control symptoms.

Common medications include:

  • Methimazole: The most commonly prescribed medication to reduce thyroid hormone production.
  • Propylthiouracil (PTU): May be used during early pregnancy or in selected situations.
  • Beta-Blockers (such as propranolol or atenolol): Help relieve rapid heart rate, tremors, anxiety, and other symptoms while thyroid hormone levels are being controlled.
  • Teprotumumab: May be recommended for selected individuals with moderate to severe Graves’ eye disease.

Learn More

Methimazole – NIH MedlinePlus
https://medlineplus.gov/druginfo/meds/a682464.html

Provides information about methimazole, proper use, side effects, and monitoring.

Teprotumumab – American Thyroid Association
https://www.thyroid.org/

Provides information about newer treatment options for Graves’ eye disease.

Procedures

Some people with Graves’ disease require procedures to treat hyperthyroidism or evaluate complications. The type of procedure depends on the severity of the disease, your age, overall health, and whether medications successfully control your thyroid hormone levels.

Common procedures may include:

  • Radioactive Iodine Therapy: A common treatment that uses radioactive iodine to destroy overactive thyroid tissue. This treatment often results in hypothyroidism, requiring lifelong thyroid hormone replacement.
  • Thyroidectomy: Surgical removal of part or all of the thyroid gland. Surgery may be recommended for large goiters, thyroid nodules, thyroid cancer, pregnancy when medications are not appropriate, or hyperthyroidism that cannot be controlled with other treatments.
  • Thyroid Ultrasound: Uses sound waves to evaluate thyroid enlargement, nodules, or structural abnormalities.
  • Eye Evaluation: People with Graves’ eye disease may undergo specialized eye examinations to assess vision, eye movement, eye pressure, and corneal health.

Learn More

American Thyroid Association – Graves’ Disease
https://www.thyroid.org/graves-disease/

Learn about radioactive iodine therapy, thyroid surgery, and treatment options for Graves’ disease.

What Should You Expect Long-Term?

Most people with Graves’ disease respond well to treatment and are able to live healthy, active lives. Some individuals achieve long-term remission with anti-thyroid medications, while others require radioactive iodine therapy or thyroid surgery.

Many people who undergo radioactive iodine therapy or thyroid surgery eventually develop hypothyroidism and require lifelong thyroid hormone replacement. Regular follow-up appointments and blood tests help ensure thyroid hormone levels remain within a healthy range.

What Can You Do At Home?

Daily self-care can help improve symptoms and reduce the risk of complications.

Helpful tips include:

  • Take your medications exactly as prescribed.
  • Attend regular healthcare appointments.
  • Have your thyroid hormone levels checked as recommended.
  • Do not smoke or vape, especially if you have Graves’ eye disease.
  • Eat a balanced diet.
  • Stay physically active as tolerated.
  • Get enough sleep.
  • Manage stress.
  • Use lubricating eye drops if recommended for dry or irritated eyes.
  • Wear sunglasses outdoors if you have light sensitivity.
  • Report new or worsening symptoms promptly.

Learn More

American Thyroid Association
https://www.thyroid.org/

Provides practical guidance for living well with Graves’ disease and managing Graves’ eye disease.

Frequently Asked Questions

What is the difference between Graves’ disease and hyperthyroidism?

Graves’ disease is an autoimmune disorder that causes hyperthyroidism. Hyperthyroidism refers to the condition of having too much thyroid hormone and can have several different causes.

Will I need medication forever?

Some people only require anti-thyroid medications for a period of time and then go into remission. Others eventually need lifelong thyroid hormone replacement after radioactive iodine therapy or surgery.

Can Graves’ disease affect my eyes?

Yes. Graves’ eye disease may cause bulging eyes, eye irritation, dryness, double vision, light sensitivity, or vision changes. Not everyone with Graves’ disease develops eye involvement.

Can smoking make Graves’ disease worse?

Yes. Smoking significantly increases the risk of developing Graves’ eye disease and can worsen existing eye symptoms. Quitting smoking is strongly recommended.

How often should my thyroid levels be checked?

Your healthcare provider will determine how often your thyroid function should be monitored. Blood tests are commonly repeated after starting or adjusting treatment and then periodically once your thyroid hormone levels are stable.

Questions To Ask Your Provider

Consider asking your healthcare provider:

  • What is the best treatment option for my Graves’ disease?
  • Am I a candidate for radioactive iodine therapy or surgery?
  • Will I eventually develop hypothyroidism?
  • Do I have Graves’ eye disease?
  • How often should my thyroid levels be checked?
  • Should I see an endocrinologist or ophthalmologist?
  • When should I schedule my next follow-up appointment?

Specialist Referrals

Many people with Graves’ disease receive care from a team of healthcare professionals.

You may be referred to:

  • Endocrinologist: Specializes in thyroid disorders and hormone-related conditions.
  • Ophthalmologist: Evaluates and treats Graves’ eye disease and vision problems.
  • Endocrine Surgeon: Performs thyroid surgery when indicated.
  • Otolaryngologist (ENT Surgeon): May perform thyroid surgery in some cases.
  • Registered Dietitian: Provides nutrition guidance to support healthy weight and overall wellness.

Learn More

American Thyroid Association
https://www.thyroid.org/

Provides patient education about Graves’ disease, specialty care, and treatment options.

Is Graves’ Disease Curable?

Some people achieve long-term remission after treatment with anti-thyroid medications. Others receive definitive treatment with radioactive iodine therapy or thyroid surgery.

Although these treatments effectively control hyperthyroidism, many people develop hypothyroidism afterward and require lifelong thyroid hormone replacement. With appropriate treatment and regular monitoring, most people live healthy, active lives.

Emergency Symptoms / When To Seek Immediate Help

Call 911 or seek emergency medical care immediately if you experience:

  • Chest pain
  • Difficulty breathing
  • Loss of consciousness
  • Severe confusion
  • Very rapid or irregular heartbeat
  • High fever with severe agitation, confusion, or excessive sweating
  • Severe weakness
  • Sudden vision loss

These symptoms may be signs of thyroid storm, a rare but life-threatening complication of severe hyperthyroidism.

Seek prompt medical evaluation if you notice:

  • Worsening eye pain or swelling
  • Double vision
  • Increasing heart palpitations
  • Significant weight loss
  • Persistent symptoms despite treatment

Learn More

Graves’ Disease – NIH MedlinePlus
https://medlineplus.gov/gravesdisease.html

Learn about Graves’ disease, possible complications, and when emergency medical care is needed.

CALL 911

APNS does not provide emergency medical services. If you believe you are experiencing a medical emergency, including (but not limited to) chest pain, difficulty breathing, stroke symptoms, severe allergic reactions, anaphylaxis, uncontrolled bleeding, seizures, loss of consciousness, or any other potentially life-threatening condition, you are instructed to call 911 immediately or go immediately to the nearest emergency department.

Official Resources / External Links

Graves’ Disease – NIH MedlinePlus
https://medlineplus.gov/gravesdisease.html

Easy-to-understand information about Graves’ disease, including symptoms, diagnosis, treatment, and long-term management.

American Thyroid Association – Graves’ Disease
https://www.thyroid.org/graves-disease/

Comprehensive patient education about Graves’ disease, Graves’ eye disease, medications, radioactive iodine therapy, surgery, and follow-up care.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
https://www.niddk.nih.gov/health-information/endocrine-diseases

Reliable information about thyroid disease and other endocrine disorders.

Hormone Health Network
https://www.hormone.org/

Evidence-based patient education about thyroid disorders, Graves’ disease, autoimmune thyroid disease, and endocrine health.

This guide is intended for educational purposes only and should not replace medical advice, diagnosis, or treatment from your healthcare provider. Always follow the recommendations of your healthcare team regarding your individual health needs. Contact your healthcare provider if your symptoms worsen, new symptoms develop, or your treatment is no longer controlling your Graves’ disease. Call 911 immediately if you experience chest pain, difficulty breathing, severe confusion, loss of consciousness, sudden vision loss, or symptoms of thyroid storm or another medical emergency.

Get personalized care for Graves’ Disease

At APNS, our providers take the time to understand your condition and your goals. We offer comprehensive telehealth visits at a fixed rate — no membership fees, no insurance required, and no unexpected charges. Whether you’re newly diagnosed or looking for a provider who actually listens, we’re here to help.