Graves’ Disease

What is Graves' Disease?

Graves' disease is an autoimmune disease that mainly affects the thyroid gland, and it is the most common cause of hyperthyroidism.^{[1, 2]} Antibodies against the thyroid-stimulating hormone (TSH) receptor activate it and cause it to release too much hormone.^[2] It needs medical treatment, and complementary care cannot control it.

Common symptoms

Excess thyroid hormone speeds up the body, so common symptoms include weight loss, a fast or irregular heartbeat, heat intolerance and sweating, tremor, nervousness, tiredness, muscle weakness, poor sleep and loose stools. An enlarged thyroid (goiter) is also common.^{[1, 2]}

The same antibodies can cause Graves' orbitopathy, with dry or irritated eyes, swelling around the eyes, double vision or bulging eyes, and can sometimes cause thickened skin on the shins.^{[2, 3]} Severe eye disease can threaten sight and needs prompt specialist care.^[3]

Causes and risk factors

The exact cause is unknown. Genetic factors account for most of the risk, and the disease is 5 to 10 times more common in women, mostly between ages 30 and 60.^[4] Smoking, excess iodine, and low selenium or vitamin D have been linked to the disease, and smoking is the most important modifiable risk factor for eye disease.^{[4, 5]}

How it is diagnosed and treated conventionally

Diagnosis uses blood tests of thyroid hormones and TSH, and often thyroid antibody tests, ultrasound or a radioactive iodine uptake scan.^{[1, 2]} No treatment that targets the cause is yet available. The established options are antithyroid drugs, radioactive iodine and surgery.^[6]

Each has trade-offs. Antithyroid drugs can cause problems in pregnancy, radioiodine can worsen eye disease, and surgery can damage the parathyroid glands or the nerve of the voice box.^[2] Moderate to severe eye disease is usually treated with intravenous glucocorticoids, and newer targeted drugs are being tested.^[6]

Why Graves' Disease calls for a whole-person approach

Graves' disease affects the thyroid, the eyes, the heart, sleep and mood together, so care often involves an endocrinologist and sometimes an eye specialist. Genes, hormones and environmental factors such as smoking and iodine all play a part.^[4]

Supportive care can address how a person feels during treatment. It does not change the antibodies or hormone levels.

Immune activity

The antibodies that activate the TSH receptor drive the thyroid overactivity, and in orbitopathy they work together with another receptor to cause swelling and inflammation behind the eyes.^[2] This immune process is the target of medical treatment.

Smoking and iodine

Smoking is the most important modifiable risk factor for Graves' orbitopathy, and excess iodine has been linked to Graves' disease.^{[4, 5]} Excess iodine can also cause thyroid dysfunction in susceptible people, including people with existing thyroid disease.^[7]

Stress, sleep and mood

The condition itself can cause anxiety and poor sleep, and severe emotional or physical stress is among the triggers of thyroid storm in poorly controlled hyperthyroidism.^[8] This is why stress and sleep deserve attention alongside medical treatment.

Acupuncture as supportive care in Graves' Disease

What the research shows

The evidence is very limited. A 2018 narrative review of 29 clinical projects including 1,757 patients with thyroid disorders found reduced symptoms and improved biomarkers with acupuncture alone or combined with other treatment, but the reviewer called for better-designed research.^[9] The review is narrative and not a controlled meta-analysis, so it cannot show that acupuncture works.

One small Chinese trial of 52 people with hyperthyroid exophthalmos compared acupuncture plus medicine with medicine alone. Eye signs improved more in the acupuncture group, but 8 people had bleeding and 8 had bruising there, and the trial was small.^[10] Needling near the eyes carries real risk, and we do not treat the area around the eyes.

We found no good evidence that acupuncture lowers thyroid hormone or antibody levels, and we make no such claim.

How acupuncture may work

No reliable mechanism has been shown for acupuncture in Graves' disease. Any benefit for stress or sleep would be a general effect and is not a treatment for the immune process.

What treatment involves

Treatment uses fine, sterile, single-use needles at points chosen for the symptoms being addressed, usually left in place for about 20 to 40 minutes. A short course of visits is followed by reassessment.

In prospective studies, about 9 in 100 patients had a minor reaction such as bleeding, pain or redness at a needle site, and serious events occurred in about 1 in 10,000 patients.^[11] Tell the practitioner about heart rhythm problems, a pacemaker, blood thinners or bleeding disorders, and pregnancy.

Ayurvedic medicine as supportive care in Graves' Disease

The Ayurvedic view

Ayurveda has no single classical condition that matches Graves' disease. Practitioners may describe the heat, restlessness, sweating and weight loss in terms of aggravated Pitta and Vata, but this is a traditional framework and not a medical diagnosis.

Therapies that may be used

Care is individualized and may include:

• Regular meals, cooling foods and a steady sleep routine
• Breathing practices and gentle movement for stress and restlessness
• Warm oil massage for relaxation, away from the neck
• Herbs only after a review of your thyroid results and medicines, from tested sources because some Ayurvedic products sold online contain lead, mercury or arsenic^[12]

Panchakarma procedures are not appropriate during pregnancy, acute illness or frailty, and we do not use them while hyperthyroidism is uncontrolled.

What the research shows

We found no clinical trials of Ayurvedic medicine for Graves' disease or hyperthyroidism. This also means no Ayurvedic herb has been shown to be safe or helpful for it.

One herb of concern is ashwagandha (Withania somnifera), popular for stress. A review of its endocrine effects reported increased thyroid hormone secretion in some studies, and a 2026 review of adverse effects linked it to thyrotoxicosis.^{[13, 14]} For that reason, people with Graves' disease should not take it without their endocrinologist's approval.

Herbal medicine as supportive care in Graves' Disease

Herbs and formulas that have been studied

Most research is on Chinese herbal formulas used together with antithyroid drugs. A 2024 network meta-analysis covered capsules, granules and decoctions including Bailing capsule, Jiakangling, Prunella vulgaris (xiakucao) preparations and Yinjia pellet.^[15] In traditional Chinese medicine, Graves' disease is classed as Ying Bing, a kind of goiter, and Haizao Yuhu decoction is a classic formula for it.^[16]

What the research shows

The evidence is moderate at best and comes from a few studies. A 2025 multicenter, double-blind, placebo-controlled trial in 186 people with Graves' hyperthyroidism (150 in the efficacy analysis) tested Pingkang granules, modified from Haizao Yuhu decoction, over 12 weeks. TRAb antibody levels fell in the group that took the granules together with methimazole, and thyroid hormone levels fell in all three arms. No severe adverse events were reported.^[16] The trial was short, measured blood markers, and was run under medical supervision.

A 2024 network meta-analysis of 35 randomized trials with 2,828 patients concluded that several Chinese medicines improved response rates and hormone levels compared with Western medicine.^[15] Such pooled comparisons depend on the quality of the underlying trials, and most compared the herbs with or added them to Western medicine. An earlier randomized trial of 80 patients with neurologic manifestations of Graves' disease, using a goiter dispersion formula plus antithyroid drugs, reported higher response and changes in inflammatory markers than drugs alone.^[17]

None of this supports using herbs in place of antithyroid medicine. Patients must not stop or lower their medicines.

Safety and herb-drug interactions

Iodine is a particular concern. Seaweed such as kelp can contain large amounts of iodine, and excess iodine can trigger or worsen thyroid dysfunction.^[7] Iodine exposure is also a recognized trigger of thyroid storm.^[8]

Herbs can interact with medicines, and some affect bleeding or blood pressure.^[18] Tell us about every medicine you take, including methimazole or propylthiouracil, beta blockers and any thyroid hormone. Tell us about pregnancy, breastfeeding, and liver or kidney disease. Herbs are prescribed individually and are not a replacement for treatment.

Translating traditional medicine into modern biological language

This is interpretation, not equivalence. Chinese medicine describes Graves' disease as Ying Bing, a kind of goiter.^[16] Practitioners may also describe patterns such as liver qi stagnation, phlegm and yin deficiency with fire. Researchers instead measure antibodies, thyroid hormones and inflammatory markers, and the trials above used those measures.^{[16, 17]}

In Ayurveda, aggravated Pitta describes heat and restlessness. No study has shown that doshas or TCM patterns correspond to the antibodies that drive Graves' disease.

How this care fits with your medical care

Supportive care is complementary. For a condition like this, we ask that you are under a physician's care for it and that your treating team knows you are receiving complementary care.

Keep your endocrinologist, thyroid blood tests and eye checks. Do not stop, skip or change antithyroid medicine or beta blockers on your own, because abrupt discontinuation of antithyroid medication is a recognized trigger of thyroid storm.^[8] We do not diagnose Graves' disease or manage thyroid function.

Please bring your diagnosis, recent thyroid blood tests and antibody results, eye examination reports, a list of medicines and supplements, and any plans for radioactive iodine or surgery.

When to seek urgent medical care

Some features of Graves' disease are emergencies. Thyroid storm is rare and life-threatening, with high fever, a very fast heartbeat and confusion.^[8]

• High fever with a very fast heartbeat, agitation, confusion, vomiting or heavy sweating
• Chest pain, an irregular heartbeat or shortness of breath
• Sudden vision loss, double vision, severe eye pain or an eye that cannot close
• Difficulty breathing or swallowing from neck swelling
• Fainting or severe weakness
• Pregnancy with hyperthyroidism and any new symptoms

For emergencies, call 911 or go to the nearest emergency department.