What causes Graves' disease?

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Last updated: April 1, 2025View editorial policy

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From the Guidelines

Graves' disease is an autoimmune disorder that occurs when the immune system mistakenly attacks the thyroid gland, causing it to overproduce thyroid hormones, and its development is influenced by genetic predisposition, female sex, advancing age, and other factors, as noted in studies such as 1 and 1. The exact cause of Graves' disease is not fully understood, but several factors contribute to its development.

  • Genetic predisposition plays a significant role, as people with family members who have Graves' disease are at higher risk.
  • Women are more likely to develop the condition than men, particularly between ages 30 and 50.
  • Stress, pregnancy, and viral infections may trigger the onset of Graves' disease in genetically susceptible individuals.
  • Smoking increases the risk and can worsen symptoms. The disease involves the production of abnormal antibodies called thyroid-stimulating immunoglobulins (TSIs) that mimic thyroid-stimulating hormone (TSH), causing the thyroid to produce excess hormones, as discussed in 1. This autoimmune response may be linked to other autoimmune conditions like rheumatoid arthritis or type 1 diabetes. While Graves' disease cannot be prevented, early diagnosis and treatment can help manage symptoms and prevent complications, and treatment options include antithyroid medications, radioactive iodine, or surgery, as recommended in 1 and 1. It is essential to note that the development of Graves' disease is complex and multifactorial, and further research is needed to fully understand its causes and risk factors, as highlighted in 1.

From the Research

Causes of Graves' Disease

  • Graves' disease is an autoimmune disorder that causes hyperthyroidism, and its exact cause is not fully understood 2, 3, 4, 5, 6.
  • However, research suggests that it may be triggered by a combination of genetic and environmental factors, such as stress, infection, and hormonal changes 3, 4.

Risk Factors for Developing Graves' Disease

  • Family history: Individuals with a family history of Graves' disease or other autoimmune disorders are more likely to develop the condition 3, 4.
  • Gender: Women are more likely to develop Graves' disease than men 2, 5.
  • Age: Graves' disease can occur at any age, but it is most common in people between the ages of 20 and 50 4, 6.

Triggers for Graves' Disease

  • Radioiodine treatment: Some studies suggest that radioiodine treatment may trigger Graves' disease in some individuals, particularly those who are prone to autoimmune disorders 3, 6.
  • Antithyroid drugs: Certain antithyroid drugs, such as propylthiouracil, may reduce the effectiveness of radioiodine treatment and increase the risk of developing Graves' disease 6.
  • Other factors: Other potential triggers for Graves' disease include stress, infection, and hormonal changes, although more research is needed to fully understand the relationship between these factors and the development of the condition 3, 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Increased Risk of Radioiodine Treatment Failure Associated with Graves Disease Refractory to Methimazole.

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2020

Research

Radioactive Iodine Therapy of Graves' Disease in Patients Pretreated With Methimazole Without Radioiodine Uptake for Dose Estimation.

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2024

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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