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Other risk factors being assigned female at birth having a family history of Graves disease living with another autoimmune disease, such as rheumatoid arthritis One theory is that smoking can Smoking cigarettes may also exacerbate Graves disease symptoms such as: racing heartbeat hand tremors difficulty sleeping weight loss muscle weakness itchy skin The chemicals in cigarettes, such as nicotine, can stimulate the immune system in a way that worsens autoimmune responses, leading to more severe symptoms of hyperthyroidism

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