People with "neurologic" autoimmune disorders, or autoimmune disorders that result in damage to the nerve/neurologic system (like multiple sclerosis) should avoid Botox because of uncertainty as to whether it could aggravate or worsen those diseases. Grave's disease and autoimmune thyroiditis which are more common and affect the thyroid gland and do not directly involve the nerve/neurologic system will not be impacted by Botox treatment. In other words, it should be fine to have Botox despite having autoimmune thyroid disease. Another example of an autoimmune disease that does not directly affect the nerve system would be celiac disease and would normally be compatible with Botox treatment. However, if someone had very severe celiac disease that was giving them some nerve/neurologic symptoms (as has been reported), then I would caution them against having Botox. Bottom line, if you have autoimmune thyroid disease and it is well controlled and you have no unexplained nerve symptoms, then Botox is safe. To reassure you further, I have had many patients over the years who take thyroid medication for their autoimmune thyroid disease, and they did absolutely fine with Botox treatment.