Three Common Graves Disease Treatment Options

Graves disease is on the rise and is the most common cause of hyperthyroidism. This autoimmune disease develops antibodies that attack the thyroid, causing it to produce more hormones than the body needs.

This excess of hormones causes a wide variety of symptoms, including:

• Nervousness, anxiety, irritability
• Hyperactivity – you have nervous energy and find it hard to sit still
• Mood swings
• Insomnia
• Constant tired feeling 
• Heat sensitivity 
• Muscle weakness
• Diarrhea
• Needing to urinate more often than usual
• Constant thirst
• Itchiness
• No interest in sex

There are also these physical signs:

• Swollen thyroid gland (goiter)
• Heart palpitations    
• Trembling hands
• Moist, warm skin and unusual sweating
• Loosening nails
• Hives
• Hair loss or patchy thinning
• Weight loss – even with an increased appetite
• Eye issues – known as Thyroid Eye Disease, a common symptom of Graves disease

Causes of Graves Disease

There are several causes of Graves disease, including:

• A malfunction of the immune system causes excess thyroid antibodies to attack the thyroid gland.
• Thyroid nodules (lumps) may have thyroid tissue adding to the excess of thyroid hormones. It is unknown why people develop nodules.
• Medications containing iodine may cause your thyroid to produce too many hormones. One medicine containing iodine is amiodarone, which is used for an irregular heartbeat. Once you stop taking medicine, your thyroid will improve, but it usually takes a few months to get back to normal.
• A pituitary adenoma is a non-cancerous tumor in the pituitary gland. The pituitary gland regulates the hormones produced by the thyroid.
• Functional medicine and holistic doctors believe toxins, stress, and poor nutrition are the leading causes of an overworked, stressed, and contaminated thyroid. Therefore, these doctors look for the root cause of the disease, focusing on treating the whole body by removing environmental toxins, releasing stress, and supplementing the nutrients depleted by the disease.

They base their treatment plans on the testing done on blood, urine, and saliva samples that are collected. These doctors also recommend removing as many toxins as possible from your diet, personal care items, and cleaning products.
The toxic chemicals in these products have a cumulative effect, so even if they only have minute amounts of a harmful chemical, they build up in our bodies over time, mimicking hormones and causing disruptions to the messages sent within the endocrine system.

For example, the thyroid is one of the glands in this system, so when it’s not getting the correct messages or the proper nutrition, its function is disrupted, and symptoms appear.
The issue with toxins in our environment is growing and becoming more detrimental to our health.

Diagnosing Graves Disease

The first step is a blood test. I had to chuckle at the research I did for this post. The sites all mentioned the blood tests done to diagnose thyroid disorders. They discussed testing two thyroid hormones, thyroxine (free T-4) and triiodothyronine (free T-3). If your free T-4 and free T-3 are higher than normal and your TSH levels are lower than normal, you are hyperthyroid, citing Graves disease as a likely cause.

Here’s the thing: if you go to a conventional doctor for a thyroid issue, they will only test your TSH level. However, you will be allowed more testing if your TSH levels are abnormal. Several thyroid sites mention the testing that can be done; however, most insurance companies will only pay for the initial TSH test and only allow additional testing if your TSH results are abnormal.

This is because insurance companies base most of their coverage limits on guidelines set by the CDC, and they recommend a TSH test to start with, adding additional tests if your TSH levels are out of the normal range.

Once you have blood work that shows a dysfunctional thyroid, they will do a blood test looking for anti-thyroid antibodies. These antibodies are present if you have Graves disease. When checking for antibodies, they may also check your erythrocyte sedimentation rate (ESR), which tests for inflammation in the body.

If there is inflammation, the rise in thyroid hormones is likely due to thyroiditis (inflammation of the thyroid).

You may also have a thyroid scan to look for nodules on your thyroid.
You’ll swallow a small pill with a slightly radioactive substance that the thyroid will absorb. It may also be injected. A scan is then done to measure the amount of substance absorbed and see your thyroid’s size and shape.

Three Common Graves Disease Treatment Options

Anti-thyroid medications (ATD)-

Most patients start with ATD treatment when initially diagnosed with Graves’ with the intention of remission, which happens when the antibody is no longer present. This treatment is successful for 25% to 30% of Graves’ patients, leaving the rest to have the disease reoccur after stopping ATD treatment. They either continue with chronic ATD therapy or consider RAI.

The American Thyroid Association studied patients with a history of Graves’ disease but experienced a relapse after ending ATD treatment. The study compared results from patients who chose repeat ATD therapy or RAI. They followed the patients an average of 6 years from the relapse.

The study revealed those who chose long-term ATD therapy vs. RAI showed increased thyroid function. Those who decided on RAI were more likely to be hypothyroid at the 60-month follow-up; also, Graves’ eye disease developed more often in patients who chose RAI. Body weights were higher in patients treated with RAI vs. ATD.

The authors also noted no significant adverse effects from long-term ATD therapy and concluded it to be a safe and effective treatment for Graves’ and were preferred by most patients.

Radioactive Iodine Therapy (RAI)-

This type of radiotherapy destroys the cells in the thyroid gland, lowering the number of hormones it produces. RAI is the most popular treatment for an overactive thyroid.

You swallow a capsule that contains iodine and a low dose of radiation, which is then absorbed by your thyroid. Many only need one treatment.

It takes a few weeks for the benefits to be noticed, so you may need to take carbimazole or propylthiouracil.

The amount of radiation used during RAI is very low, but you need to take some precautions after treatment.

 After treatment, avoid close contact with children and pregnant women, women should avoid getting pregnant for a minimum of 6 months, and men should not father a child for a minimum of 4 months.

RAI is not for pregnant women or those breastfeeding. It’s also not to be used if your hyperthyroidism is causing severe eye problems.

Surgical Removal of the thyroid gland-

• Surgery may be an option if your thyroid gland is swollen due to a large goiter.
• You have severe eye problems caused by Graves’ disease.
• Your symptoms have returned after using other treatments.
• Removal of the thyroid gland is recommended because it keeps the symptoms of hyperthyroidism from returning.
• After thyroid surgery, you will be given thyroid hormone replacement medicine. You will take these hormones for the rest of your life. You will be given the identical hormone replacement as those who are hypothyroid.

Graves’ Disease Complications-

Thyroid Eye Disease

Approximately one-third of patients with Graves’ disease develop thyroid eye disease or Graves’ ophthalmopathy.

Symptoms include:

• watering eyes
• sensitivity to light
• blurred or double vision
• eyes feeling dry and gritty
• red eyes
• bulging eyes
• red, swollen or pulled back eyelids

Most cases are mild and improve as you are treated for an overactive thyroid, but about 1 in every 20 to 30 patients risk vision loss.

If you have eye problems, you will be referred to an ophthalmologist for treatment, including eye drops, steroids, or possible surgery.

Underactive thyroid

Treating an overactive thyroid often leads to hormone levels becoming too low, resulting in hypothyroidism.

Underactive thyroid symptoms include:

• moodiness
• sensitivity to cold
• weight gain
• tiredness
• depression
• constipation
• joint and muscle pain

While an underactive thyroid is sometimes temporary, depending on the treatment, it’s often permanent, requiring long-term treatment with thyroid hormone medicine.

Pregnancy issues

If you have Graves’ disease during your pregnancy and your condition is not well monitored, you may be at an increased risk due to:

• Pre-eclampsia is high blood pressure that develops after 20 weeks of pregnancy. Doctors believe this occurs when there’s an issue with the placenta, which links the mother’s blood supply to the baby’s.
• Miscarriage
• Premature labor and birth occurring before week 37 of pregnancy.
• Babies with low birth weight.

Talk with your doctor when planning a pregnancy or if you think you may be pregnant.

They will want to check to be sure your condition is controlled, and if you are pregnant may suggest switching to treatments that will not harm the baby, such as propylthiouracil.

Keep in mind some Graves’ treatments can harm an unborn baby.

Thyroid storm

Occasionally, an poorly controlled or undiagnosed overactive thyroid can lead to a life-threatening condition known as a thyroid storm.

This sudden flare-up of symptoms can be set off by:

• Pregnancy
• An infection
• Damage to the thyroid gland, like a hit to the throat
• Not taking prescribed medication or taking medication incorrectly

Symptoms of a thyroid storm:

• A high temperature
• A rapid heartbeat
• Diarrhea and feeling ill
• Confusion and severe agitation 
• Yellowing of the eyes and skin (aka jaundice)
• Loss of consciousness

Caution: Thyroid storms are medical emergencies, call 911 and request an ambulance immediately! 

Other problems related to Graves’ disease

An overactive thyroid also increases your chances of developing these issues:

Heart failure: your heart cannot pump blood throughout the body properly.

Osteoporosis: This condition thins the bones making them more likely to beak.

Atrial fibrillation: this heart condition causes an irregular and abnormally fast heart rate.

Environmental toxins, stress, and poor nutrition

The problems caused by environmental toxins are growing and becoming more detrimental to our health; add the stress from our crazy world; fueled by a diet that offers little nutritional value, and it’s no surprise autoimmune diseases are on the rise.
While working on this post, I received several emails from functional medicine doctors referencing how toxins, stress, and poor nutrition negatively affect our thyroids and overall health.

Doctor #1

The first doctor sent four or five emails over two weeks, sharing how we are exposed daily to thousands of synthetic chemicals.

He focused on bringing awareness to the dangers of phthalates and other estrogen mimickers.

Even though we buy products labeled “BPA-free,” “paraben-free,” or “phthalates-free,” he urged us to “not be fooled.”

The doctor warned that these “safer replacements” have almost the same chemical structure as BPA, so they act similarly in your body.

 A recent study of 171 pregnant women found increased exposure to the BPA substitutes Bisphenol-S (BPS) and Bisphenol-F (BPF). This increase is concerning since crucial male sexual development occurs during pregnancy, so this information affects future generations.

• Bisphenol-S (BPS): This compound has almost entirely replaced BPA; this estrogen-mimicking chemical is a thyroid hormone disruptor and may also cause DNA damage and raise the risk of heart disease.
• Bisphenol-F (BPF): Another replacement for BPA, this chemical cousin has been shown to have significant hormone-disrupting effects. Studies revealed it alters organ weight, causes reproductive damage, and alters enzyme expression. BPF dramatically increases the risk of obesity.

He stated that eight health advocate groups got together to sue the FDA and demand that they ban endocrine-disrupting chemicals called phthalates from our food, citing their anti-androgenic effect on our libido, fertility, and testosterone levels.

He also added the FDA is resisting calls to ban phthalates with every resource, even with proof that these chemicals cause hormone disruption.

Research shows that exposure is linked to:

• Causing reproductive and genital defects
• Interfering with the male reproductive tract development
• Early onset of puberty
• Lower testosterone levels in adolescent males
• Lower sperm count in adult males
• Interfering with the normal functioning of the hormone system

You will find phthalates in dairy products, fish, baked goods, and meat. Even baby formulas have these disruptive chemicals.

It’s not just our food; phthalates make plastic products more flexible, and these chemicals can enter through the skin.

That wasn’t the only email he sent- he also sent one talking about “estrogen dominance” in men, which is the result of exposure to “xenoestrogens.”

Xenoestrogens are manufactured chemicals with a similar structure to the female hormone estrogen. This structure allows them to efficiently bind to your estrogen receptors, where they send out feminizing messages. As a result, the de-masculinization begins, including reduced male hormone production, a drop in energy, increased lower body fat storage, and “man-boobs.”

Common xenoestrogen offenders include:

• Plastics
• Pesticides (from non-organic foods)
• Cosmetics
• Cleaning products
• Tap water

Doctor #2

The next doctor talked about iodine and bromide and their link to the rise in thyroid disease. Bromide is made from an ion of bromine, which is in the same chemical family as iodine. Bromide is highly toxic.

When referencing the periodic table of elements, bromine and iodine are in Group 7; this group has chemically similar elements called halogens.

So if a person is exposed to excess bromine, the body accumulates that element instead of iodine since one halogen can inhibit another, and iodine is usually the element to be overtaken.

He also talked about two other halogens; fluorine and chlorine. Two of the four halogens he spoke about are essential: chlorine (chloride compounds) and iodine (iodides). These two we cannot live without.

However, the doctor states that fluorine and bromine (fluorides and bromides) are nonessential. He adds there is no know therapeutic function for bromine in the human body, with the medical community knowing it’s a goitrogen, meaning that accumulation in the thyroid can cause swelling or goiter. In addition, researchers have found higher bromide levels in those diagnosed with thyroid cancer.

He also addressed the fact that most conventional doctors will recommend RAI as the first treatment option without even bringing up using anti-thyroid medications when treating Garves’ disease.

He talked about how he was taught in medical school that adding iodine to salt solved the thyroid problems of the day. But the switch to sea salt by home cooks reduced the amount of iodine in the diet, and thyroid issues started to rise. 

These doctors stressed how these chemicals are linked to developing thyroid disease and other autoimmune diseases, stressing the importance of eliminating as many toxic chemicals as possible from our lives.

For those interested in a program focused on healing your thyroid thru diet and nutritional support, I encourage you to check out the Hypothyroidism Solution. (We may receive a commission if you purchase through the links in this post.) Even though it targets hypothyroidism, it will give you the guidance you need to feed your thyroid the nutrients it needs to heal and ease those nasty symptoms.

For those dealing with menopause, this program helps balance all those out-of-control hormones. Menopause causes an upheaval of sex and thyroid hormones, creating many uncomfortable symptoms. 

The Thyroid Factor eases those symptoms and balances your hormones.

The programs I mentioned above are similar to the program my doctor laid out for me. His guidelines helped me get my health and energy back so I could enjoy life again. P.S. I’m playing golf again!

Take care,

Corri

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016749
https://www.endocrineweb.com/news/thyroid-diseases/61831-whats-best-treatment-graves-disease
https://www.webmd.com/women/understanding-graves-disease-treatment
https://www.endocrineweb.com/conditions/graves-disease/how-eat-well-when-you-have-graves-disease
https://www.nhs.uk/conditions/overactive-thyroid-hyperthyroidism/diagnosis/
https://www.thyroid.org/patient-thyroid-information/ct-for-patients/january-2016/vol-9-issue-1-p-8-9/#:~:text=Several%20treatment%20options%20exist%20for,%2Dthyroid%20medications%20(ATD).
https://www.nhs.uk/conditions/pre-eclampsia/