What is Graves' disease and the modern triggers behind increasing cases

From anxiety-like symptoms to heart palpitations, Graves' disease often goes unnoticed. Doctors explain what modern triggers may be responsible

Heart palpitations, unexplained weight loss and constant anxiety are increasingly being traced back to a little-known autoimmune disorder. Graves’ disease, once considered uncommon, is now being diagnosed more frequently, particularly among young adults. As cases rise in clinics, experts are questioning whether modern stress, infections and lifestyle changes are playing a role in triggering this overactive thyroid condition.

 

What is Graves’ disease?

 

Graves’ disease is an autoimmune disorder in which your immune system wrongly attacks your thyroid, a small gland at the front of your neck that regulates metabolism, energy levels and body temperature. This attack triggers the thyroid to produce too much thyroid hormone, leading to a condition known as hyperthyroidism. "This extra amount causes increased heart rate and metabolism along with other severe symptoms if left untreated," says Dr Rakesh Pandit, Senior Consultant & HOD, Internal Medicine, Aakash Healthcare, Delhi.

 

Unlike temporary thyroid issues, Graves’ disease is typically lifelong, although treatments can effectively control symptoms and improve quality of life.

 

Who is most at risk?

 

Certain groups are more vulnerable to developing Graves’ disease:

 

• The condition is significantly more common in females than males
• While it can occur at any age, it often appears in early adulthood or middle age
• Having a relative with thyroid or autoimmune issues increases risk
• People with disorders like Type 1 diabetes or rheumatoid arthritis are also at a higher risk.

 

Modern triggers behind the rise

 

Although the exact cause remains unknown, experts increasingly believe that environmental and lifestyle factors interact with genetic predispositions to trigger Graves’ disease. Some modern contributors are:

 

Chronic stress: Long-term emotional or psychological stress may disrupt immune balance and trigger autoimmune reactions.

Infections: Viral or bacterial infections, including common viruses, might set off immune responses in susceptible individuals.

Excess iodine exposure: Too much iodine, often found in certain diets or supplements, can overstimulate the thyroid.

Environmental toxins: Pollutants and chemicals that disrupt hormone systems are increasingly suspected of influencing thyroid autoimmunity.

Smoking: Tobacco use is a known risk enhancer and can worsen ocular symptoms of Graves’ disease.

Hormonal shifts: Particularly in women, changes like pregnancy or postpartum immune shifts may act as triggers.

 

Some studies also suggest that Covid-19 infection and in rare cases, even Covid-19 vaccine may act as a trigger for Graves’ disease in individuals with a susceptible immune system, although researchers stress the need for further investigation and emphasise that vaccines remain safe and crucial for public health.

 

"Genetics sets the stage, while environmental and lifestyle triggers push the immune system into attacking the thyroid," shares Dr Hetashvi Gondaliya, Diabetes & Endocrinology, Ck Birla Hospitals, Jaipur.

 

Spotting the signs early

 

Graves’ disease affects the whole body, so symptoms can seem unrelated at first. Common signs include:

 

• Rapid or irregular heartbeat
• Unexplained weight loss despite normal appetite
• Tremors
• Nervousness, irritability or anxiety
• Heat intolerance and excessive sweating
• Fatigue and muscle weakness
• Sleeping difficulties
• Goitre (visible swelling at the throat)
• Bulging eyes (Graves' ophthalmopathy)
• Double vision, light sensitivity or other eye issues
• Menstrual changes

 

"It's important to note that not all individuals with Graves' disease will experience all of these symptoms, and the severity can vary widely from person to person," adds Dr Pandit.

 

How is Graves’ disease diagnosed?

 

"Diagnosis involves clinical examination by an endocrinologist, blood tests for thyroid hormones and specific antibodies, along with imaging when required," explains Dr Gondaliya.

 

Blood tests - To measure thyroid hormones (T3, T4) and thyroid-stimulating hormone (TSH).

Antibody tests - To detect thyroid-stimulating immunoglobulin (TSI), a marker of Graves’ disease.

Imaging - Ultrasound or radioactive iodine uptake scans help assess thyroid activity.

 

Treatment options for managing the condition

 

"Currently, Graves' disease has no cure, but with effective treatment and lifestyle changes, many patients can manage symptoms and achieve remission," says Dr Pandit.

 

Antithyroid medications: Drugs like methimazole reduce hormone production.

Beta-blockers: Help manage symptoms such as racing heartbeat and tremors.

Radioactive iodine therapy: Destroys overactive thyroid cells to reduce hormone levels.

Surgery: Thyroidectomy may be recommended in severe or refractory cases.

 

Living well with Graves’ disease

 

Appropriate treatment and consistent follow-up can lead to remission in up to 50 per cent of patients, shares Dr Pandit. Outcomes depend on several factors, including how severe the disease is at diagnosis, the treatment approach chosen, and how consistently patients follow medical advice.

"With timely diagnosis, medications combined with stress management, smoking cessation, and regular follow-up can provide effective long-term control and good quality of life," says Dr Gondaliya. As triggers are often modern and environmental, awareness is the first step toward timely diagnosis and treatment.   

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This report is for informational purposes only and is not a substitute for professional medical advice.