Excess thyrotropin receptor (TSHR) activation occurs in two common conditions, Graves’ disease (GD) in which thyroid-stimulating antibodies (TSAB) mimic thyroid-stimulating hormone (TSH) causing hyperthyroidism and primary hypothyroidism when elevated circulating TSH compensates for low thyroid hormone (T4/T3) levels resulting from the failing gland (1). Here, TSHR is linked to hyperthyroidism.