Graves’ Disease is an autoimmune disease affecting the thyroid gland. It is characterized by an overactive thyroid, called hyperthyroidism. This is due to an overproduction of T3 and T4 hormones. Consequently, thyroid stimulating hormone, TSH, is severely suppressed, causing abnormally low laboratory values. Low TSH is often the first indicator of Graves’ disease. The primary driver of Graves’ is abnormally high levels of thyroid-stimulating immunoglobulin (TSI). TSI is an antibody that is produced when the autoimmune response occurs. TSI overstimulates the thyroid gland by mimicking TSH. Some people may experience Smoldering Graves’ Disease, in which antibodies stay present for more than five years even with first-line treatment anti-thyroid drugs such as methimazole. Graves’ is more prevalent in women than in men and is commonly diagnosed between 20-50 years of age.
