Graves' disease
Autoimmune conditionThe most common cause of an overactive thyroid. Antibodies switch the thyroid 'on' so it makes too much hormone.
What happens
Antibodies called TSI (or TRAb) attach to the thyroid and stimulate it nonstop, speeding up the whole body. Some people also develop thyroid eye disease, in which the tissue behind the eyes swells.
Who gets it
Graves' disease is several times more common in women and usually starts between 30 and 50. Smoking raises the risk of eye involvement.
Common signs
- A racing or pounding heartbeat
- Anxiety, irritability, or shakiness
- Feeling hot and sweating more
- Weight loss despite a good appetite
- More frequent bowel movements
- Trouble sleeping
- Lighter or less frequent periods
- Bulging, gritty, or red eyes, or double vision
Labs to ask about
- TSH (usually low)
- Free T4 and T3 (usually high)
- TSI or TRAb antibodies
- A thyroid uptake scan in some cases
How it's usually treated
- Beta-blockers to calm the heart rate and tremor
- Antithyroid medicine (usually methimazole)
- Radioactive iodine or surgery for some people
- Care from an eye specialist for thyroid eye disease
Supportive steps to discuss with your provider
- Stop smoking. It makes eye disease worse.
- Avoid iodine-rich supplements such as kelp.
- Stop biotin a few days before thyroid labs. It can skew the results.
- Ask about calcium and vitamin D. Too much thyroid hormone thins bones.
- Selenium may help mild thyroid eye disease. Ask your eye doctor.
See a doctor promptly if you have
- Chest pain, a very fast or irregular heartbeat, or fainting
- High fever with agitation or confusion: call 911 (possible thyroid storm)
- Eye pain, vision loss, or double vision
- You're pregnant or planning pregnancy with an overactive thyroid
Related conditions
Hashimoto's thyroiditis
The most common cause of an underactive thyroid in the US. The immune system slowly damages the thyroid, so it makes less hormone over time.
Learn more →Type 1 diabetes
The immune system destroys the insulin-making cells in the pancreas, so the body can't make enough insulin to control blood sugar.
Learn more →Vitiligo & alopecia areata
Two autoimmune conditions of the skin and hair. Vitiligo destroys pigment cells, leaving white patches. Alopecia areata attacks hair follicles, causing patchy hair loss.
Learn more →
Wondering if your symptoms fit a pattern?
Dr. Lesher is a naturopathic doctor who specializes in women's autoimmune and chronic conditions. Since 2020, she has helped more than 900 patients overcome and heal from their conditions.