What Is Graves Disease?

The thyroid’s production of thyroid hormones—T3 and T4—is regulated by thyroid-stimulating hormone (TSH), which is made by the pituitary gland.
Graves’ disease, also known as toxic diffuse goiter, is the most common cause of hyperthyroidism in the United States. Hyperthyroidism is a disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs.

The Thyroid
The thyroid is a 2-inch-long, butterfly-shaped gland in the front of the neck below the larynx, or voice box. The thyroid makes two thyroid hormones, triiodothyronine (T3 ) and thyroxine (T4 ). T3 is made from T4 and is the more active hormone, directly affecting the tissues. Thyroid hormones circulate throughout the body in the bloodstream and act on virtually every tissue and cell in the body.
Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels. Hyperthyroidism causes many of the body’s functions to speed up.
Thyroid hormone production is regulated by another hormone called thyroid-stimulating hormone (TSH), which is made by the pituitary gland in the brain. When thyroid hormone levels in the blood are low, the pituitary releases more TSH. When thyroid hormone levels are high, the pituitary responds by decreasing TSH production.

Autoimmune Disorder
Graves’ disease is an autoimmune disorder. Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. But in autoimmune diseases, the immune system attacks the body’s own cells and organs.
With Graves’ disease, the immune system makes an antibody called thyroid-stimulating immunoglobulin (TSI)—sometimes called TSH receptor antibody—that attaches to thyroid cells. TSI mimics TSH and stimulates the thyroid to make too much thyroid hormone. Sometimes the TSI antibody instead blocks thyroid hormone production, leading to conflicting symptoms that may make correct diagnosis more difficult.
What are the symptoms of Graves’ disease?

People with Graves’ disease may have common symptoms of hyperthyroidism such as

  • nervousness or irritability
  • fatigue or muscle weakness
  • heat intolerance
  • trouble sleeping
  • hand tremors
  • rapid and irregular heartbeat
  • frequent bowel movements or diarrhea
  • weight loss
  • goiter, which is an enlarged thyroid that may cause the neck to look swollen and can interfere with normal breathing and swallowing


In addition, the eyes of people with Graves’ disease may appear enlarged because their eyelids are retracted—seem pulled back into the eye sockets—and their eyes bulge out from the eye sockets. This condition is called Graves’ ophthalmopathy (GO).
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