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What Causes Graves’ Disease

What Causes Graves’ Disease

What Causes Graves’ Disease And How To Manage It

Exactly what causes Graves’ disease is not known. However, like all autoimmune conditions, a combination of genetic, gut microbiome, and environmental factors are to blame. Graves’ disease is caused when an antibody known as TSH receptor antibody (TRAb) stimulates the TSH receptor located on the thyroid gland. This stimulation causes the thyroid gland to become overactive and produce too much thyroid hormone. The excess hormone produced by an overactive thyroid can cause symptoms such as weight loss, anxiety, tremors, rapid heartbeat, and bulging eyes.1

Testing For Graves’ Disease

No single test can diagnose Graves’ disease, so a combination of tests and physical examinations are used to confirm the diagnosis. These tests typically include a thyroid-stimulating hormone (TSH) test, a free thyroxine (FT4) test, and an antithyroid antibody test. A radioactive iodine uptake test or a thyroid ultrasound may also be used to confirm the diagnosis. Treatment for Graves’ disease typically includes prescribing antithyroid medications, beta-blockers, and radioiodine therapy.2

What Causes Graves’ Disease

What Causes Graves’ Disease – Genetics

Genetics plays a role in Graves’ disease. It is believed that certain genetic factors may make people more likely to develop the condition. It has been found that siblings and children of people with Graves’ disease are at an increased risk of developing the disorder themselves. Additionally, those who have other autoimmune disorders such as Hashimoto’s thyroiditis or Addison’s disease may be more likely to develop Graves’ Disease.3

What Causes Graves’ Disease – Environmental Factors

Research suggests that certain environmental triggers can play a role in causing the onset of Graves’ disease. These include stressful life events such as death or divorce, exposure to radiation and other toxins, a poor diet and obesity, a lack of activity or exercise, and exposure to certain medications such as interferon.

Other environmental factors include smoking and alcohol abuse, long-term use of drugs that suppress the immune system, such as those used in organ transplantation, and excessive intake of caffeine-containing beverages.

It is important to note that the presence of any one of these environmental factors does not necessarily mean that Graves’ disease will develop.4

The Similarities Between Graves’ Disease And Hashimoto’s Thyroiditis

Graves’ disease and Hashimoto’s thyroiditis are two of the most common forms of autoimmune thyroid diseases. Both affect the thyroid glands, which are responsible for regulating metabolism in the body. Despite their differences, Graves’ disease and Hashimoto’s thyroiditis share a few similarities.

One similarity between Graves’ disease and Hashimoto’s thyroiditis is that they are both autoimmune diseases. An autoimmune disorder occurs when the body’s immune system mistakenly attacks its own cells, tissues, and organs. This leads to abnormal antibody production that attacks the thyroid gland instead of protecting it from foreign invaders. As a result, the thyroid gland doesn’t function properly, which can cause symptoms of hyperthyroidism or hypothyroidism.5

Read more about Hashimoto’s Thyroiditis.

What Causes Graves’ Disease

The Overlap Between Graves’ Disease And Addison’s Disease

Individuals who suffer from Addison’s Disease are also susceptible to Graves’ Disease in 9% of cases. Addison’s Disease is a chronic illness caused by dysfunction of the adrenal glands, which are located on top of each kidney. Symptoms can include fatigue, low blood pressure, weight loss, darkening skin pigmentation, salt cravings, and depression.6

Read more about Addison’s Disease.

What Causes Graves’ Disease And How To Manage It

Although it is not always possible to prevent Graves’ disease, maintaining a healthy lifestyle can help reduce the risk. This includes quitting smoking, managing stress levels, eating properly, consuming enough essential minerals, and maintaining adequate vitamin D levels.

What Causes Graves’ Disease – Stress

Stress has been linked to an increased risk of Graves’ disease. Stress causes the release of hormones like cortisol, which can suppress the immune system and lead to inflammation. Practicing stress-reduction techniques like yoga, meditation, and mindfulness can help reduce the risk of developing Graves’ disease.7

What Causes Graves’ Disease – Dietary Choices

Certain dietary factors have been suggested as contributors to Graves’ disease, including a high-sugar diet, gluten intolerance, and food sensitivities.8 9 Avoiding these foods can help reduce inflammation in the digestive tract.

Graves’ Disease And Vitamin D

Vitamin D is important for maintaining healthy bones and plays a role in regulating the body’s immune system. There is some evidence that low levels of Vitamin D may be associated with Graves’ Disease. Additionally, studies have suggested that Vitamin D supplementation may help reduce the severity of Graves’ Disease symptoms.10

Read more about the connection between vitamin D and autoimmune disorders.

What Causes Graves’ Disease – High Iodine Intake

High iodine intake is a known cause of Graves’ disease. Iodine plays an important role in the production of thyroid hormones, however, too much iodine can contribute to Graves’ disease.11

What Causes Graves’ Disease – Low Selenium Intake

Selenium is an essential mineral for the body that helps regulate the immune system and thyroid hormones. Low selenium intake has been linked to Graves’ disease, as this mineral plays a vital role in controlling inflammation. Studies have shown that people with Graves’ disease tend to have lower levels of selenium than those without the condition. Additionally, low selenium intake has been linked to an increased risk of developing Graves’ disease and other autoimmune thyroid disorders.12

Selenium is found naturally in food sources such as fish, nuts, seeds, whole grains, and legumes. Brazil nuts are an extremely rich source of selenium.13

What Causes Graves’ Disease - Low Selenium Intake

What Causes Graves’ Disease – Low Zinc Intake

Low zinc intake can be a contributing factor to Graves’ Disease. Zinc is essential for the proper functioning of the immune system, and when levels in the body are low, it can lead to an overactive immune response that causes Graves’ Disease. A diet that is low in zinc-rich foods such as oysters, pumpkin seeds, beef, spinach, and nuts can lead to low zinc intake and contribute to Graves’ Disease. 

Additionally, those who take medications such as antibiotics or corticosteroids that interfere with the body’s ability to absorb zinc are at an increased risk for developing Graves’ Disease.14

What Causes Graves’ Disease – Iron

Iron deficiency, also called anemia, is a common cause of Graves’ disease. When the body lacks iron, it cannot produce enough thyroxine, which results in an overproduction of hormones from the thyroid gland. Women are more likely to be deficient in iron due to their menstrual cycles and pregnancy. Symptoms of iron deficiency can include fatigue, pale skin, brittle nails, and headaches.15

What Causes Graves’ Disease – Smoking

Smoking has long been identified as a risk factor for Graves’ Disease, and it is one of the most important modifiable risk factors. Studies have consistently shown that smokers are at higher risk of developing Graves’ Disease than non-smokers. In addition, those who continue to smoke after being diagnosed with Graves’ Disease may experience a more severe course of the disease, with higher levels of symptoms and an increased risk for complications. Quitting smoking is essential for anyone diagnosed with Graves’ Disease, as it can reduce their risk for further health complications from the condition.

It is important to note that second-hand smoke exposure is also associated with an increased risk of Graves’ Disease. Those who are exposed to second-hand smoke, either at home or in the workplace, should take steps to reduce their exposure levels as much as possible to lower their risk of developing Graves’ Disease.11

What Causes Graves’ Disease – Gut Microbiotica

Recent research suggests that the gut microbiome, or the trillions of bacteria living inside our digestive tract, may play a role in Graves’ disease. The microbiota helps with digestion and absorption of nutrients, produces vitamins and other molecules necessary for health, and protects us from pathogens. 

An imbalance in the composition of this complex microbial ecosystem can lead to inflammation and an overactive immune system, which contribute to the development of Graves’ disease.14 16

What Causes Graves’ Disease

What Causes Graves’ Disease And How To Manage It

Now that you know what causes Graves’ Disease, an overproduction of thyroid hormone, there are some things you can do to manage the condition. First of all, reduce overall stress levels, quit smoking, and consume a healthy diet that includes plenty of vitamins and minerals. Specifically, make sure you are consuming enough vitamin D, selenium, zinc, and iron-containing foods to reduce the severity of Graves’ Disease.

Read more about thyroid disorders.


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6 Meling Stokland AE, Ueland G, Lima K, Grønning K, Finnes TE, Svendsen M, Ewa Tomkowicz A, Emblem Holte S, Therese Sollid S, Debowska A, Singsås H, Landsverk Rensvik M, Lejon H, Sørmo DE, Svare A, Blika S, Milova P, Korsgaard E, Husby Ø, Breivik L, Jørgensen AP, Sverre Husebye E. Autoimmune Thyroid Disorders in Autoimmune Addison Disease. J Clin Endocrinol Metab. 2022 May 17;107(6):e2331-e2338. doi: 10.1210/clinem/dgac089. PMID: 35226748; PMCID: PMC9113809.

7 Fukao A, Takamatsu J, Arishima T, Tanaka M, Kawai T, Okamoto Y, Miyauchi A, Imagawa A. Graves’ disease and mental disorders. J Clin Transl Endocrinol. 2019 Oct 11;19:100207. doi: 10.1016/j.jcte.2019.100207. PMID: 31763175; PMCID: PMC6864135.

8 Paul DT, Mollah FH, Alam MK, Fariduddin M, Azad K, Arslan MI. Glycemic status in hyperthyroid subjects. Mymensingh Med J. 2004 Jan;13(1):71-5. PMID: 14747791.

9 Ashok T, Patni N, Fatima M, Lamis A, Siddiqui SW. Celiac Disease and Autoimmune Thyroid Disease: The Two Peas in a Pod. Cureus. 2022 Jun 23;14(6):e26243. doi: 10.7759/cureus.26243. PMID: 35911325; PMCID: PMC9312543.

10 Kim D. The Role of Vitamin D in Thyroid Diseases. Int J Mol Sci. 2017 Sep 12;18(9):1949. doi: 10.3390/ijms18091949. PMID: 28895880; PMCID: PMC5618598.

C Knezevic J, Starchl C, Tmava Berisha A, Amrein K. Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function? Nutrients. 2020 Jun 12;12(6):1769. doi: 10.3390/nu12061769. PMID: 32545596; PMCID: PMC7353203.

11 Antonelli A, Ferrari SM, Ragusa F, Elia G, Paparo SR, Ruffilli I, Patrizio A, Giusti C, Gonnella D, Cristaudo A, Foddis R, Shoenfeld Y, Fallahi P. Graves’ disease: Epidemiology, genetic and environmental risk factors and viruses. Best Pract Res Clin Endocrinol Metab. 2020 Jan;34(1):101387. doi: 10.1016/j.beem.2020.101387. Epub 2020 Feb 4. PMID: 32107168.

12 Guastamacchia E, Giagulli VA, Licchelli B, Triggiani V. Selenium and Iodine in Autoimmune Thyroiditis. Endocr Metab Immune Disord Drug Targets. 2015;15(4):288-92. doi: 10.2174/1871530315666150619094242. PMID: 26088475.

13 Cardoso BR, Duarte GBS, Reis BZ, Cozzolino SMF. Brazil nuts: Nutritional composition, health benefits and safety aspects. Food Res Int. 2017 Oct;100(Pt 2):9-18. doi: 10.1016/j.foodres.2017.08.036. Epub 2017 Aug 14. PMID: 28888463.

14 Knezevic J, Starchl C, Tmava Berisha A, Amrein K. Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function? Nutrients. 2020 Jun 12;12(6):1769. doi: 10.3390/nu12061769. PMID: 32545596; PMCID: PMC7353203.

15 Gianoukakis AG, Gupta S, Tran TN, Richards P, Yehuda M, Tomassetti SE. Graves’ disease patients with iron deficiency anemia: serologic evidence of co-existent autoimmune gastritis. Am J Blood Res. 2021 Jun 15;11(3):238-247. PMID: 34322286; PMCID: PMC8303011.

16 Zheng D, Liao H, Chen S, Liu X, Mao C, Zhang C, Meng M, Wang Z, Wang Y, Jiang Q, Xue Y, Zhou L, Chen Y. Elevated Levels of Circulating Biomarkers Related to Leaky Gut Syndrome and Bacterial Translocation Are Associated With Graves’ Disease. Front Endocrinol (Lausanne). 2021 Dec 16;12:796212. doi: 10.3389/fendo.2021.796212. PMID: 34975767; PMCID: PMC8716831.

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