Graves' Disease and Pregnancy: What You Need to Know

Graves' disease is a condition that involves too much thyroid hormone, which is produced by an overactive thyroid gland. This is called hyperthyroidism.

During pregnancy, untreated hyperthyroidism may lead to life-threatening complications for you and your baby. Graves' disease is the most common type of pregnancy-related hyperthyroidism.

Graves’ disease can run in families. Anyone can get it, but it most often develops in biological females under 40—in other words, during potential childbearing years. It sometimes comes on during pregnancy. But you can have a successful pregnancy with Graves' disease.

This article looks at what Graves’ disease is, fertility and pregnancy risks, how it’s diagnosed and treated, and how to avoid possible complications.

A female doctor examines the thyroid of a pregnant person.

IuriiSokolov / Getty Images

A Rare Occurance

Despite being the most common cause of hyperthyroidism during pregnancy, Graves’ disease is still fairly uncommon. It only affects 0.2% of pregnant women.

What Is Graves' Disease?

Graves’ disease is an autoimmune condition, but it's an unusual one. In most autoimmune diseases, your immune system creates antibodies that attack and damage a healthy body part. 

In Graves’ disease, researchers suspect an antibody directly triggers excess thyroid hormone production. That leads to problems with hormone balance.

When Graves’ disease comes on outside of pregnancy, it can cause fertility problems regardless of your biological sex. It can cause:

  • Irregular menstrual periods
  • Missed ovulation
  • Damaged sperm

Fortunately, treatment often restores fertility.

Symptoms of Graves' Disease

When you have too much thyroid hormone, it speeds up a lot of processes and changes the way your body deals with energy and growth. Common symptoms include:

  • Rapid, irregular heartbeat
  • High blood pressure
  • Nervousness and irritability
  • Increased sweating
  • Shaking hands
  • Unintended weight loss or lack of pregnancy weight gain
  • Goiter (bulge in the front of the neck from an enlarged thyroid gland)
  • Bulging eyes
  • Thinning skin
  • Brittle hair
  • Weakness in the limbs
  • Increased bowel movements
  • Sleep problems
  • Confusion

During pregnancy, your baby may be exposed to high levels of thyroid hormone. This can cause a goiter in the unborn baby.

If you have Graves’ disease before pregnancy, immune-system fluctuations may worsen symptoms early, then improve in the second and third trimesters. Symptoms may worsen again after delivery as your immune function returns.

Causes of Graves' Disease in Pregnancy

During pregnancy, your thyroid hormone levels naturally increase. The thyroid gland may get a little bigger but not enough to cause a goiter.

In some people, though, immune-system changes trigger hyperthyroidism. This causes levels that are higher than what's normal during pregnancy.

Researchers aren’t sure why Graves’ disease develops in some pregnancies and not in others.

Graves' Disease in Pregnancy Diagnosis

Graves’ disease is diagnosed the same whether it’s during pregnancy or not. Healthcare providers look at:

  • Your personal and family health history
  • Your symptoms
  • A physical exam
  • A blood test to measure your thyroid hormone levels

Because Graves’ symptoms are similar to those of other conditions, your healthcare provider may also run additional tests.

Treating Graves' Disease in Pregnancy

A common treatment for hyperthyroidism is radioactive iodine, which damages overactive thyroid cells so they produce less. However, this treatment isn’t safe for your baby, so it’s not used during pregnancy.

Treatments that are used during pregnancy include:

  • Frequently monitoring thyroid hormone levels
  • Anti-thyroid medications, if the need outweighs the risk
  • Surgery to remove the overactive portion of the thyroid

Treatment Goals

The goal of treatment for Graves' disease is to maintain normal thyroid hormone levels.

Pre-Pregnancy Graves' Disease

Before getting pregnant with Graves' disease, you should discuss any needed treatment changes with your healthcare provider. Ideally, you should switch treatments and get the disease stable before conceiving. 

Realistically, though, pregnancy can come as a surprise. If that’s the case, be sure to let your healthcare provider know as soon as you discover you’re pregnant. Don’t discontinue treatments without first talking to a healthcare provider.

Complications of Graves' Disease in Pregnancy

Successful treatment generally prevents serious pregnancy complications from Graves’ disease. If it’s not well treated or left untreated, you may develop:

  • Preeclampsia: A potentially life-threatening condition involving high blood pressure. It can lead to seizures, stroke, organ failure, and death of the parent or baby.
  • Placental abruption: The placenta detaches from the uterus before the baby is born. This can lead to fetal distress and early emergency delivery.
  • Congestive heart failure: Your heart loses pumping power and fluid builds up in your body.
  • Thyroid storm: Significant increase in thyroid activity that’s potentially life-threatening.

Several possible problems can affect your baby, including:

These problems are rare with proper treatment. To avoid them, be sure to discuss any new, changing, or worsening symptoms with your healthcare provider.


Graves’ disease is the most common type of hyperthyroidism during pregnancy. It involves a misfiring immune system that increases thyroid hormone levels. This speeds up many bodily processes.

Untreated Graves’ disease can be dangerous or catastrophic for you and your unborn child. Proper diagnosis and treatment are crucial for a good outcome.

A Word From Verywell 

Considering pregnancy with Graves’ disease can be frightening. So is finding out you have Graves’ during pregnancy. Good treatments are readily available, though, and they can protect you and your child from possible complications. Being alert to symptoms and sticking with your treatment plan is key.

Frequently Asked Questions

  • Can you pass Grave's disease to your baby while pregnant?

    The antibody that causes Graves’ disease can get into your baby’s bloodstream and cause high hormone levels. If you have high antibody levels, your healthcare provider can monitor your baby’s thyroid hormones.

  • Is it safe to get pregnant with Graves' disease?

    Yes, if Graves' disease is well managed. It's best to talk to your healthcare provider before you get pregnant, change medications if needed, and make sure your disease is stable before you conceive.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Nguyen CT, Sasso EB, Barton L, Mestman JH. Graves' hyperthyroidism in pregnancy: a clinical review. Clin Diabetes Endocrinol. 2018;4:4. doi:10.1186/s40842-018-0054-7

  2. U.S. Department of Health & Human Services, Office on Women’s Health. Graves’ disease.

  3. National Institute of Diabetes and Digestive and Kidney Diseases. Graves' disease.

  4. Preeclampsia Foundation. What is preeclampsia.

  5. MedlinePlus. Placenta abruption - definition.

  6. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Dictionary definition: congestive heart failure.

  7. MedlinePlus. Thyroid storm.

Additional Reading

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.