Graves' disease

Female sex: People who are female develop autoimmune thyroid overactivity more often. Hormone patterns across the lifespan may raise susceptibility.

Young adulthood: The condition most often begins between ages 20 and 50. Immune activity is high in these years, which may add risk.

After pregnancy: In the months after delivery, immune defenses rebound and can misfire against the thyroid. This postpartum window can trigger Graves' disease.

Autoimmune conditions: People living with another autoimmune condition have higher odds of a second autoimmune thyroid problem. Shared immune pathways raise overall risk.

Thyroid antibodies: Thyroid-targeting antibodies found in a blood test, even without symptoms, signal higher future risk. This immune activity can lead to Graves' disease.

Neck radiation: Prior radiation to the head or neck can alter thyroid tissue and immune responses. This exposure is linked with later thyroid disease.

Iodine contrast: Medical imaging dyes high in iodine can suddenly overstimulate a vulnerable thyroid. In some, this surge can unmask or worsen Graves' disease.

Iodine-rich drugs: Certain heart medicines carry a very high iodine load. In vulnerable thyroids, they can trigger or aggravate overactive thyroid function.

Cancer immunotherapy: Immune checkpoint inhibitors and similar treatments can unleash the immune system against the thyroid. This can lead to new-onset Graves' disease or flare an existing condition.

Interferon therapy: Treatments such as interferon-alpha can tilt the immune system toward thyroid autoimmunity. Some people develop autoimmune hyperthyroidism during or after therapy.

Smoking: Cigarette smoking is strongly linked to a higher risk of Graves’ disease and to more severe thyroid eye disease. Quitting can reduce eye complications and may lower relapse risk.

High iodine intake: Diets or supplements high in iodine (such as kelp or seaweed products) can trigger or worsen hyperthyroidism in Graves’. Aim for consistent, not excessive, iodine intake unless your clinician advises otherwise.

Chronic stress: Ongoing psychosocial stress is associated with a higher likelihood of Graves’ onset and flares. Stress-reduction practices may help stabilize disease activity alongside medical care.

Sleep problems: Short, poor-quality, or irregular sleep can disrupt immune balance and may worsen hyperthyroid symptoms in Graves’. A steady sleep schedule can support symptom control and recovery.

Intense exercise: Vigorous or high-intensity workouts during active hyperthyroidism can strain the heart and worsen muscle loss. Favor gentle to moderate activity until thyroid levels are controlled.

Alcohol use: Heavy alcohol use can aggravate bone loss and heart strain already increased by hyperthyroidism. If you drink, keep it light to moderate and avoid alcohol during unstable disease.

Caffeine and stimulants: High caffeine or decongestants with stimulants can intensify palpitations, anxiety, and tremor in Graves’. Cutting back may reduce symptom burden while treatment takes effect.

Low selenium intake: Inadequate selenium status is linked to worse thyroid inflammation and thyroid eye disease in Graves’. Selenium-rich foods (such as fish, eggs, and Brazil nuts) or clinician-guided supplementation may support eye outcomes.

Don’t smoke: Smoking raises the chances of Graves’ disease and makes thyroid eye disease more likely and more severe. Quitting lowers these risks over time and supports better treatment results.

Iodine caution: Very high iodine intake can trigger or worsen overactive thyroid in people prone to Graves’. Avoid high‑dose iodine or kelp/seaweed supplements unless your doctor advises them.

Know early signs: Unexplained weight loss, a fast or pounding heartbeat, heat intolerance, nervousness, or hand tremor can be early symptoms of Graves’ disease. If these show up, ask about a thyroid blood test.

Regular monitoring: If thyroid problems run in your family or you live with another autoimmune condition, ask for periodic thyroid checks. Catching changes early often prevents severe symptoms and eye complications.

Medication review: Some drugs and medical dyes contain large amounts of iodine and can affect thyroid levels. Tell your care team about all medicines and supplements so they can guide safe choices.

Pregnancy planning: If you’ve had Graves’ or thyroid antibodies before, plan thyroid checks during pregnancy and after delivery. Timely monitoring helps protect both parent and baby.

Healthy routines: Consistent sleep, regular physical activity, and balanced nutrition support overall immune and thyroid health. These habits won’t prevent Graves’ on their own, but they can reduce strain on your body.

Ongoing hyperthyroidism: Long-term overactivity can persist or flare, keeping metabolism high. This may mean fast heartbeat, heat sensitivity, tremor, and weight loss over time.

Thyroid eye disease: Eye tissues can stay inflamed or scar, causing bulging, gritty dryness, or double vision. For some, changes remain even when thyroid levels are normal.

Heart rhythm issues: In Graves' disease, long-standing high thyroid hormones raise the risk of irregular heartbeat, especially atrial fibrillation. This can lead to palpitations, shortness of breath, or reduced exercise tolerance.

Bone thinning: Years of excess thyroid hormone speed up bone turnover and lower bone density. In Graves' disease, this increases fracture risk, especially in the hips and spine.

Mood and thinking: Anxiety, irritability, and sleep problems can linger or recur. Some notice brain fog, poor concentration, or low mood even after treatment.

Goiter effects: In Graves' disease, a long-lasting enlarged thyroid may cause neck fullness or pressure. Rarely, it can lead to trouble swallowing or a hoarse voice.

Hypothyroidism after treatment: After radioactive iodine or surgery, many develop long-term low thyroid function. This state brings slower metabolism, weight gain, and feeling cold.

Relapse patterns: Graves' disease can remit and return over the years. Some long-term issues can resemble early symptoms of Graves' disease, such as fast heartbeat and heat sensitivity.

Pregnancy and fertility: In Graves' disease, unstable thyroid levels can affect menstrual cycles and fertility. During pregnancy, uncontrolled Graves' disease increases risks such as high blood pressure, preterm birth, and effects on the baby’s thyroid.

Skin changes: Some develop thick, itchy skin over the shins. This can be long-lasting but is usually mild.

Radioiodine therapy: A small dose of radioactive iodine is taken by mouth to shrink an overactive thyroid. It is a non-surgical option that often corrects high hormone levels over weeks to months. Your doctor will discuss eye risks and ways to protect your vision if you have thyroid eye disease.

Thyroid surgery: Removing most or all of the thyroid can quickly resolve overactivity. It is considered when other treatments aren’t suitable or when a large goiter causes pressure or swallowing trouble. You’ll need lifelong thyroid hormone after surgery.

Smoking cessation: Quitting smoking lowers the chance and severity of thyroid eye disease. It also improves healing if you need procedures for Graves’ disease. Support programs and nicotine replacement can raise quit rates.

Iodine awareness: Avoid high-iodine supplements like kelp and tell clinicians about Graves’ disease before imaging with iodinated contrast. Too much iodine can worsen an overactive thyroid. Ask your care team how to manage unavoidable exposures.

Eye self-care: Lubricating eye drops, cool compresses, and wraparound sunglasses can soothe dryness, light sensitivity, and grit-like irritation. Sleeping with the head raised and gently taping the eyelids closed can help if lids don’t fully shut. These steps are safe alongside other Graves’ disease treatments.

Selenium supplement: In mild thyroid eye disease, a daily selenium supplement may ease eye discomfort and slow worsening. Benefits are most likely in areas where selenium intake is low. Ask your doctor which non-drug options might be most effective and safe for you.

Stress reduction: Relaxation breathing, mindfulness, or gentle yoga can calm jitteriness and help steady heart rate. People with Graves’ disease often notice fewer flares of anxiety and better sleep with regular practice. Not every approach works the same way for everyone.

Sleep routines: A regular sleep schedule and a cool, dark room can reduce fatigue and irritability. Limiting late caffeine and screens may help you fall asleep more easily. Simple routines—like winding down at the same time nightly—can have lasting benefits.

Activity pacing: Short, frequent walks and light strength work support heart health and protect muscles and bones. Start low and build slowly as thyroid levels come under control. If exercise triggers palpitations or breathlessness, pause and check in with your clinician.

Limit stimulants: Cutting back on caffeine and alcohol can reduce tremor, palpitations, and sleep disruption. Many living with Graves’ disease find this also eases heat intolerance. Try introducing one change at a time, rather than tackling everything at once.

Eye specialist care: Prism glasses can help double vision, and protective lenses reduce dryness. In moderate to severe thyroid eye disease, treatments like orbital radiotherapy or decompression surgery may be recommended to protect sight. Some non-drug options are delivered by specialists with experience in thyroid eye disease.

Support and counseling: Cognitive behavioral therapy and peer support groups can ease stress, mood changes, and the social impact of eye symptoms. Sharing the journey with others can make daily adjustments feel more doable. These approaches are part of comprehensive Graves’ disease care.

Methimazole/Carbimazole: These antithyroid drugs lower thyroid hormone production and are often the first choice for many adults. Doctors monitor for rare side effects like low white blood cells or rash; report fever or sore throat promptly.

Propylthiouracil (PTU): PTU also blocks hormone production and is preferred in early pregnancy and certain emergencies. Because it can affect the liver, regular checks and prompt reporting of fatigue, dark urine, or jaundice are important.

Beta-blockers: Propranolol, atenolol, or metoprolol can quickly ease shaking, rapid heartbeat, and anxiety. They do not treat the thyroid itself but make day-to-day symptoms more manageable.

Iodine solutions: Potassium iodide or Lugol’s solution can temporarily “quiet” the thyroid, often before surgery or during severe flares. They are used short-term and usually alongside antithyroid drugs to avoid rebound overactivity.

Corticosteroids: Prednisone or methylprednisolone can reduce eye inflammation and swelling in thyroid eye disease. They may also slightly lower active hormone levels by slowing conversion to the more active form.

Teprotumumab: This targeted IV infusion treats moderate to severe thyroid eye disease by blocking a pathway that drives eye tissue swelling. It can improve eye bulging and double vision; monitoring for side effects like changes in blood sugar or hearing is needed.

Cholestyramine: This add-on medicine binds thyroid hormone in the gut to speed its removal from the body. It’s used short-term in difficult-to-control overactivity, with possible constipation or interference with other medicines.

Selenium supplement: In areas with low selenium intake, a short course may help mild thyroid eye symptoms. It is not a primary treatment for the overactive thyroid itself but can support eye comfort and recovery.

Lubricating eye drops: Preservative-free artificial tears ease gritty, dry, or irritated eyes in Graves’ eye disease. They are safe to use regularly and can be paired with other treatments.