On this page:

• What is Graves’ disease?
• How common is Graves’ disease?
• Who is more likely to have Graves’ disease?
• What are the complications of Graves’ disease?
• What are the symptoms of Graves’ disease?
• What causes Graves’ disease?
• How do doctors diagnose Graves’ disease?
• How do doctors treat Graves’ disease?
• How do eating, diet, and nutrition affect Graves’ disease?
• Clinical Trials for Graves’ Disease

What is Graves’ disease?

Graves’ disease is an autoimmune disorder that can cause hyperthyroidism, or overactive thyroid. The thyroid is a small, butterfly-shaped gland in the front of your neck. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats.

With Graves’ disease, your immune system attacks your thyroid gland, causing it to make more thyroid hormones than your body needs. As a result, many of your body’s functions speed up.

How common is Graves’ disease?

Graves’ disease affects nearly 1 in 100 Americans.¹ About 4 out of 5 cases of hyperthyroidism in the United States are caused by Graves’ disease.¹ 

Who is more likely to have Graves’ disease?

Graves’ disease is more common in women and people older than age 30.² You are more likely to develop the disease if you

• have a family history of Graves’ disease or Hashimoto’s disease
• have other autoimmune disorders, such as^3,4
  • vitiligo, which causes some parts of your skin to lose color
  • autoimmune gastritis, which attacks the cells in your stomach lining
  • type 1 diabetes, which occurs when your blood glucose, also called blood sugar, is too high
  • rheumatoid arthritis, which affects your joints and sometimes other parts of your body
• use nicotine products

What are the complications of Graves’ disease?

Untreated, Graves’ disease can cause serious health problems, including

• a rapid and irregular heartbeat that can lead to blood clots, stroke, heart failure, and other heart-related problems
• thinning bones, osteoporosis, and muscle problems
• problems with the menstrual cycle, fertility, and pregnancy
• eye discomfort and changes in vision

What are the symptoms of Graves’ disease?

Graves’ disease often causes symptoms of hyperthyroidism. Graves’ disease can also affect your eyes and skin. Symptoms can come and go over time.

Hyperthyroidism

Symptoms of hyperthyroidism can vary from person to person and may include⁵

• weight loss, despite an increased appetite
• rapid or irregular heartbeat
• nervousness, irritability, trouble sleeping, fatigue
• shaky hands, muscle weakness
• sweating or trouble tolerating heat
• frequent bowel movements
• an enlarged thyroid gland, called a goiter

Symptoms of hyperthyroidism may include trouble sleeping and fatigue.

Eye problems

More than 1 in 3 people with Graves’ disease develop an eye disease called Graves’ ophthalmopathy (GO).⁶ GO occurs when your immune system attacks the muscles and other tissues around your eyes. Symptoms can include

• bulging eyes
• gritty, irritated eyes
• puffy eyes
• light sensitivity
• pressure or pain in the eyes
• blurred or double vision
  

These symptoms can start before or at the same time as symptoms of hyperthyroidism. Rarely, GO can develop after Graves’ disease has been treated. You can develop GO even if your thyroid function is normal. Most people have mild symptoms.

Skin problems

Rarely, people with Graves’ disease develop a condition that causes the skin to become reddish and thick, with a rough texture. Called Graves’ dermopathy or pretibial myxedema, the condition usually affects your shins but can also develop on the top of your feet and other parts of your body. Most cases are mild and painless.     

What causes Graves’ disease?

Researchers aren’t sure why some people develop autoimmune disorders such as Graves’ disease. These disorders probably develop from a combination of genes and an outside trigger, such as a virus.

With Graves’ disease, your immune system makes an antibody called thyroid-stimulating immunoglobulin (TSI) that attaches to your thyroid cells. TSI acts like thyroid-stimulating hormone (TSH), a hormone made in your pituitary gland that tells your thyroid how much thyroid hormone to make. TSI causes your thyroid to make too much thyroid hormone.

How do doctors diagnose Graves’ disease?

Your doctor will take your medical history and perform a physical exam to look for signs of Graves’ disease. To confirm a diagnosis of Graves’ disease, your doctor may order one or more of these thyroid tests

• Blood tests. These tests can measure the levels of your thyroid hormones and also check for TSI.

• Radioactive iodine uptake test. This test measures the amount of iodine your thyroid is taking up from your bloodstream to make thyroid hormones. If your thyroid is taking up large amounts of iodine, you may have Graves’ disease.

• Thyroid scan. This test, often done together with the radioactive iodine uptake test, shows how and where iodine is distributed in your thyroid. With Graves’ disease, the iodine shows up throughout the gland. With other causes of hyperthyroidism such as nodules—small lumps in the gland—the iodine shows up in a different pattern.

• Doppler blood flow measurement. This test, also called Doppler ultrasound, uses sound waves to detect increased blood flow in your thyroid due to Graves’ disease. Your doctor may order this test if radioactive iodine uptake is not a good option for you, such as during pregnancy or breastfeeding.

How do doctors treat Graves’ disease?

Treating hyperthyroidism

Hyperthyroidism is usually treated with medicines, radioiodine therapy, or thyroid surgery. Your doctor can help you identify the best option based on your age, health, symptoms, and other factors.

This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.

The NIDDK would like to thank:
Leonard Wartofsky, M.D., M.A.C.P., Washington Hospital Center and Georgetown University Hospital