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Thyroid-stimulating immunoglobulin (TSI)
Thyrotropin receptor antibodies (TRAb)
May also test positive for anti-TPO or anti-thyroglobulin antibodies
Graves’ disease is an autoimmune condition where the immune system overstimulates the thyroid gland, causing it to produce too much thyroid hormone (a condition called hyperthyroidism). These hormones help control how the body uses energy, so when there’s too much, everything speeds up—heart rate, metabolism, and even anxiety.
It’s the most common cause of hyperthyroidism in the U.S., especially in women under 40.
Fast or irregular heartbeat
Anxiety or irritability
Shakiness or hand tremors
Weight loss despite normal or increased appetite
Sweating and heat intolerance
Difficulty sleeping
Frequent bowel movements
Menstrual changes (lighter or missed periods)
Goiter (enlarged thyroid at the front of the neck)
Bulging eyes (Graves’ ophthalmopathy) – eye irritation, redness, or pressure
Thickened skin over the shins (rare; called pretibial myxedema)
Fatigue or muscle weakness
Hair thinning or brittle hair
Graves’ disease is caused by the immune system creating autoantibodies (called TRAbs) that attack the thyroid gland, making it overproduce hormones.
Risk factors include:
Family history of thyroid or autoimmune diseases
Being female
Smoking (especially increases eye-related symptoms)
Stress, infection, or pregnancy (may trigger onset in predisposed individuals)
Doctors may perform:
Blood tests to check for high thyroid hormones (T3, T4) and low TSH
TSI test (thyroid-stimulating immunoglobulin) – confirms autoimmune cause
Thyroid ultrasound to check for enlargement or nodules
Radioactive iodine uptake scan to measure thyroid activity
Several effective treatments are available:
Anti-thyroid medications (like methimazole or PTU) to reduce hormone production
Radioactive iodine therapy to shrink or destroy overactive thyroid tissue
Thyroid surgery (rarely) to remove the gland
Beta-blockers to manage symptoms like tremors and fast heart rate
Steroids or eye drops for Graves’ eye disease
Patients treated with radioactive iodine or surgery will likely need lifelong thyroid hormone replacement (levothyroxine).
Most people can manage the condition well with treatment
Graves’ disease is not curable, but symptoms can be controlled long-term
Eye symptoms may persist or worsen even after the thyroid is under control
Without treatment, it can lead to serious complications like thyroid storm (a life-threatening state of extreme hyperthyroidism)
Affects about 1 in 200 people
7–8 times more common in women
Most common between ages 30–50, but can occur at any age
American Thyroid Association. (2023). Graves’ Disease Information.
https://www.thyroid.org/graves-disease/
Mayo Clinic. (2023). Graves’ Disease Overview.
https://www.mayoclinic.org/diseases-conditions/graves-disease
Smith, T. J., & Hegedüs, L. (2016). Graves’ disease. New England Journal of Medicine, 375(16), 1552–1565.
https://doi.org/10.1056/NEJMra1510030
NIH – National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2022). Graves’ Disease.
https://www.niddk.nih.gov/health-information/endocrine-diseases/graves-disease
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