What is Graves’ disease? Causes, Symptoms, Diagnosis, Treatment

Posted by Medical Board on January 7, 2019 in Uncategorized Last updated on January 7, 2019
New Hope for Graves’ Disease Sufferers—Symptom Relief Naturally

New Hope for Graves’ Disease Sufferers—Symptom Relief Naturally

When one 38-year old woman first noticed some swelling at the base of her neck, she didn’t think much of it.  She’d been feeling tired a lot lately and had had some trouble sleeping.   She thought she might be fighting a cold or flu virus, but became alarmed when she began losing weight.   Her doctor immediately suspected hyperthyroidism, a condition that causes the butterfly-shaped thyroid gland at the base of the throat to become overactive.  After further tests, a formal diagnosis of Graves’ disease was made.

What is Graves’ disease?

Graves disease is considered an autoimmune disorder because the body’s own immune system attacks the various tissue and organs it’s meant to protect.  In the case of Graves’ disease, the immune system creates the protein, TSI or thyroid-stimulating immunoglobulin.  This stimulates the thyroid gland into producing more hormones than necessary, which leads to hyperthyroidism, or overactive thyroid.[2]

Symptoms of Graves’ Disease

Individuals diagnosed with Graves’ Disease report a number of symptoms including:

  • Anxiety
  • Shaking, feelings of being jittery
  • Heart palpitations
  • Neck goiter
  • Frequent perspiring
  • Trouble sleeping
  • Thickening of skin on legs or feet
  • More frequent bowel movements
  • Eyes that bulge
  • Irritated eyes
  • Tearing up more often[7]

Graves’ Eye Disease (Graves’ Ophthalmopathy)

One of the most common side effects of Graves’ disease involves the eyes.  In about 50% of all Graves’ disease sufferers, Graves’ ophthalmopathy results. 

Swelling behind the eyes in the fat, tissues, and muscles causes an abnormal protrusion of the eyeballs themselves.  Often eyelids retract when swelling occurs.  This contributes to the sensation of “bulging” eyes associated with Graves’ disease and exposes the cornea of the eye to possible irritation and infection.[8]    

How common is Graves’ disease?

One in 200 individuals will develop Graves’ disease between the ages of 30 and 50 and women are eight times more likely to suffer its effects. The autoimmune disorder attacks the thyroid gland causing a condition known as “hypothyroidism”.  The thyroid gland is an important part of the overall endocrine system and controls the way in which the body uses energy.[5]

Who gets Graves’ disease?

While Graves’ disease is more prevalent in women than men, and often presents in middle age, some individuals are at a greater risk for developing the condition including:

  • Individuals related to family members with the disease
  • Those already fighting another autoimmune disease
  • Women who have been diagnosed with the infection or virus causing Epstein Barr Syndrome, or mononucleosis
  • Individuals exposed to stress
  • Women who have recently been pregnant
  • Those who smoke[6]

What causes Graves’ disease?

Graves’ disease is caused by a combination of genetic and environmental factors.  Individuals who develop Graves’ disease may have inherited certain genes that affect thyroid function or the body’s natural immune system.  Other factors such as infections, iodine levels in the body and certain medications play a major role in the development of Graves’ disease as well.[3]

How is Graves’ disease diagnosed?

In order to accurately diagnose Graves’ disease, a series of examinations and tests must be completed prior to receiving treatment for the condition.

A physician will conduct a physical exam that could reveal such symptoms as an elevated heart rate, an enlarged thyroid gland or thickening of the skin on the tops of the feet or shins.

Blood tests to measure thyroid stimulating hormone (TSH), T3, and free T4 levels will likely be ordered.  

A radioactive iodine uptake test and scan may be performed as well.

Other tests may include an ultrasound, an orbit CT Scan, a Thyroid Stimulating Immunoglobin (TSI) test, a Thyroid Peroxidase (TPO) Antibody test, and an Anti-TSH Receptor Antibody (TRAb).[4]

Who treats Graves’ disease?

Endocrinologists, general physicians and ophthalmologists work closely together to form a treatment plan that addresses all facets of Graves’ disease including eye health.

In addition to regular treatment for Graves’ disease and hyperthyroidism, the following treatment protocols may be used depending on the severity of ophthalmopathy.  

For milder cases of eye swelling the doctor may recommend keeping the head elevated at night, applying cold compresses to eyes, wearing sunglasses outside, and using eye drops to lubricate dry eyes.

More serious ophthalmopathy may require surgery on the eye muscles or eyelids, medication to shrink eye tissue, or surgery known as, orbital decompression surgery.[5]

Medical Treatment for Graves’ Disease

The course of action to treat Graves’ disease medically falls into one of three categories.  Pharmacological options, radioactive therapy, and thyroid surgery are effective treatments for Graves’ disease and the difficult symptoms of hyperthyroidism.  Doctors base treatment decisions on many factors such as the age of the patient, other medical conditions, and whether a female patient is currently pregnant.

Medication

Medication may be used to treat hyperthyroidism by either reducing the severity of symptoms or by limiting the amount of thyroid hormone produced by the actual thyroid gland.  

Anti-thyroid medication—While anti-thyroid medications don’t cure hyperthyroidism caused by Graves’ disease, they are used to control the amount of thyroid hormone produced and released from the thyroid gland.  This is one of the most efficient ways to treat the disease. 

Anti-thyroid medications used by many doctors include methimazole, propylthiouracil and carbimazole.  Side effects of these types of medications include rashes, itching, and in very rare cases liver problems.

Beta-blockers—Beta-blockers are another class of medications used for the treatment of hyperthyroidism.  While they do not limit the amount of thyroid hormone created or released from the thyroid gland itself, they do a good job relieving many of the vast number of symptoms associated with Graves’ disease and hyperthyroidism.  This includes anxiety, nervousness, rapid heartbeat and trembling.  Many of these distressing manifestations may be reduced within hours of taking a beta-blocker.  Propranolol is commonly prescribed initially in the treatment of Graves’ disease when using beta-blockers. 

Radioiodine Therapy

Administered in liquid or capsule form, radioactive therapy actively destroys the production of thyroid cells by the thyroid gland.  Most of the time, this creates a condition of hypothyroidism where thyroid levels become too low.  From a medical standpoint, this is much easier to manage however, and considered a viable treatment for hyperthyroidism. 

Thyroid Surgery

Partial or complete thyroid removal may be necessary in cases where anti-thyroid medication is not a good option, or the goiter caused by Graves’ disease becomes too large.  Once the thyroid gland has been removed, hypothyroidism (underactive thyroid) will occur.  This treatment option is used the least when managing hyperthyroidism caused by Graves’ disease.[5]

The Good News, Natural Nutrient Recommendations for Graves’ Sufferers

While no one diet has been introduced as an effective treatment for Graves’ disease, University of Maryland Medical Center recommends certain nutritional guidelines to help support the body as it deals with many of the symptoms.

Antioxidants—Antioxidants help support the body’s immune system overall and are important in fighting autoimmune diseases.  Foods such as tomatoes, bell peppers, and berries are full of antioxidant properties.

Calcium—Because Graves’ disease can cause loss of bone and the medical condition osteoporosis; it is critical to increase calcium levels with foods such as milk, cheese and yogurt.  Green leafy vegetables such as collard greens also contain high amounts of calcium.

High Protein Foods—Since Graves’ disease negatively affects muscle mass it is crucial to rebuild muscle tissue.  Protein sources include eggs, meat, mushrooms, fish and beans.

The university also recommends that Graves’ disease sufferers also abstain from:

Refined Foods—These include products with processed sugar, pasta, and breads. 

Caffeinated Drinks—Drinks such as coffee, tea, chocolate or energy drinks may aggravate some symptoms of Graves’ disease such as shakiness, anxiety, and rapid heartbeat.[1]

Although Graves’ disease can be a serious condition, there are several treatment options available, both medical and natural.  Through healthy lifestyle changes, and careful monitoring by a medical practitioner, individuals with Graves’ disease can lead full, active lives. 

References

1Aguilar, Andrea, and Michigan State University. “Graves’ Disease and Nutrition Recommendations.” Native Plants and Ecosystem Services, Michigan State University | College of Agriculture & Natural Resources, 25 Sept. 2018, www.canr.msu.edu/news/graves_disease_and_nutrition_recommendations. 

2“Graves Disease – Genetics Home Reference – NIH.” U.S. National Library of Medicine, National Institutes of Health, ghr.nlm.nih.gov/condition/graves-disease. 

3“Graves Disease – Genetics Home Reference – NIH.” U.S. National Library of Medicine, National Institutes of Health, ghr.nlm.nih.gov/condition/graves-disease#genes. 

4“Graves Disease: MedlinePlus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, medlineplus.gov/ency/article/000358.htm. 

5“Graves’ Disease.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, 1 Sept. 2017, www.niddk.nih.gov/health-information/endocrine-diseases/graves-disease. 

 6“Graves’ Disease.” Womenshealth.gov, 18 Oct. 2018, www.womenshealth.gov/a-z-topics/graves-disease. 

7“Graves’ Disease | Medical Conditions.” Rush University Medical Center, www.rush.edu/services/conditions/graves-disease. 

8Harvard Health Publishing. “Graves’ Eye Disease (Graves’ Ophthalmopathy).” Harvard Health Blog, Harvard Health Publishing, www.health.harvard.edu/a_to_z/graves-eye-disease-graves-ophthalmopathy-a-to-z.

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