The Graves’ Disease, also known as Basedow’s Disease, is one of the more recognized types of hyperthyroidism. It’s an autoimmune disorder that causes excess production of the thyroid hormone hence the name hyperthyroidism.
Inside the body of the person suffering from Graves’ Disease, antibodies known as thyroid-stimulating immunoglobulin are produced by the immune system and these antibodies attach themselves to healthy thyroid cells causing the thyroid to produce excess thyroid hormones.
These thyroid hormones affect many parts of our bodies including brain development, the nervous system, and body temperature among others. If hyperthyroidism is undiagnosed and untreated, it can lead to depression and emotional problems (emotional displays such as uncontrollable laughter or crying), mental and physical fatigue, and weight loss.
How Graves’ Disease Develops
The pituitary gland, located in the brain, produces the thyroid-stimulating hormone (TSH) that is responsible for determining how much hormones the thyroid should produce. In the case of a person suffering from Graves’ Disease, the pituitary gland is unable to communicate properly with the thyroid gland leading to release of abnormal antibodies which mimic the TSH and result in too much thyroid hormone passing into the bloodstream.
These antibodies are known by the name Thyroid Stimulating Immunoglobulin (TSI) and Thyrotropin Receptor Antibodies (TRAb). The TSH works to ensure production of adequate amounts of hormones that enable the thyroid function properly. Because the TSI antibodies mimic TSH, the body is unable to differentiate them from TSH and these antibodies trigger production of excess thyroid hormones.
Since the thyroid is unable to differentiate these antibodies from TSI, the antibodies override any warning signs from the pituitary gland and end up causing Hyperthyroidism. What follows then is the rise of TSI and TRAb levels which in turn leads to increased inflammation. This inflammation is an indication of the immune system working tirelessly and, in the process, ‘accidentally’ launching an attack on the body’s healthy tissue. An extremely detrimental cycle develops in those with Graves’ Disease because an overactive immune system leads to the damaging of bodily tissue which in turn activates and release T- cells and auto-antibodies which causes the immune system to work harder. The process starts again and continues.
T3 and T4 are some of the numerous and diverse kinds of thyroid hormones that our bodies produce. Blood test comparisons between healthy people and those with autoimmune or thyroid disorders show that the latter have low TSH, unusually high levels of T3 and T4 and a high existence of TSI.
The Graves’ Disease affects the thyroid gland which in turn affects a person’s appearance, weight, and mood. The thyroid gland secretes hormones that control our metabolism. Metabolism refers to the body’s capability ability to extract and utilize calories and nutrients from foods as to give you energy. The thyroid gland activity is hereditary so is the rate of metabolic activity and it is this metabolic activity that runs your metabolism. That is why we say that your genes determine your body weight. Your metabolic rate is controlled by the number of thyroid hormones circulating. If the thyroid gland produces an excessive amount of these hormones then the metabolism goes up and brings about weight loss, anxiety and irritability.
Hashimoto’s thyroiditis has been linked to Graves’ Disease. This autoimmune Disease is also a part of the well-known kinds of hypothyroidism. Hashimoto’s thyroiditis is known to sometimes develop when a person takes anti-thyroid medicine in order to treat Graves’ Disease. Since medication for Graves’ Disease pushes the thyroid to slow the production of thyroid hormones by the thyroid, it may lead to hypothyroidism.
Causes of Graves’ Disease
While there are many reasons that may trigger the production of excess thyroid hormones in the body Graves’ Disease is the one reason mostly associated with this. As with other autoimmune disorders, medical research is yet to establish the real cause of Graves’ Disease. That said, it is believed that the amalgamation of several factors such as poor diet, high-stress levels, genetic dispositions and exposure to particular environmental to toxins may lead to the development of Graves’ Disease.
It is also believed that there are particular genes that raise the chances of a person developing Graves’ Disease making it a hereditary Disease. It is also believed that chronic stress or a traumatic episode can trigger all kinds of autoimmune disorders. Other risk factors also come into play including the presence of other autoimmune disorders like diabetes or rheumatoid arthritis, pregnancy, a poor immune function plagued by frequent infections and smoking or use of drugs.
Our immune system is designed to counter all sorts of ‘threats’ in the body whether harmful or not. This protective mechanism undertaken by the immune system keeps us safe from infections or Diseases caused by cell mutations, bacteria, fungi or viruses. What happens in a person suffering from an autoimmune disorder is that the immune system becomes overactive and ends up affecting healthy cells, glands and organs thereby harming the body. Graves’ Disease stems from the changes in the levels of antibodies present, a situation that is mostly triggered by a high degree of inflammation.
Since the immune systems’ work is to protect the body from identified threats such as toxins in food or in the environment, it will increase the levels of antibodies, also known as ‘fighter cells’ to identify and combat anything that looks dangerous or unusual. Graves’ Disease is tied to the thyroid gland and triggers what is called an ‘organ-specific immune response’ that causes the fighter cells to attack the thyroid gland instead of increasing inflammation all over the body.
Graves’ Disease Symptoms
Graves’ Disease shares similar symptoms with hyperthyroidism which include:
- Weight loss
- Fatigue
- Heat intolerance
- Irritability
- Tachycardia (rapid heart rate)
- Difficulty in sleeping
- Muscle weakness
- Hand tremors
- Nervousness
- Increased frequency of bowel movement or diarrhea
- Goiter which is actually swelling of the thyroid gland
In addition to the above, some people may experience Graves’ dermopathy whereby the skin around the shin becomes reddened and thickened.
Graves’ ophthalmopathy is another symptom that may also occur. Here, the eyelids retract causing your eyes to seem enlarged so that it looks likes the eyes are bulging from the eye sockets. According to the National Institute of Diabetes and Digestive and Kidney Diseases, an estimated 30 percent of people suffering from Graves’ Disease develop mild Graves ophthalmopathy while 5 percent of the patients experience severe Graves’ ophthalmopathy.
Persons at Risk
Are there people particular groups of people more susceptible to Graves’ Disease? Medical experts believe this to be so. Some of the factors that put a person at risk of Graves’s Disease are:
- Age
- Heredity
- Gender
- Stress
Presence of an autoimmune disorder such as diabetes mellitus, Crohn’s Disease, and rheumatoid arthritis increase the chances of developing Graves’ Disease.
Graves’ Disease is also more prevalent in people under 40years of age. The probability of women developing the Disease is 8 times higher than that of men, while people whose family members have developed this Disease also stand a higher chance of developing it themselves.
Diagnosis
An endocrinologist, who is a doctor that specializes in hormone-related Diseases, handles the process right from ordering tests and diagnosing the problem. The doctor will look at your family history, analyze your symptoms, look at your past medical history and possibly request lab tests should they suspect that you are suffering from Graves’ Disease. Thyroid blood tests are some of the lab tests undertaken to confirm the presence of this autoimmune disorder.
- Other tests include
- Thyroid scan
- Thyroid stimulating hormone (TSH) test
- Thyroid stimulating immunoglobulin (TSI) test
- Radioactive iodine uptake test
- Blood tests
By analyzing the results from these tests, the doctor will be able to establish if you have the Graves’ Disease or if it is another kind of thyroid disorder.
Graves’ Disease and Pregnancy
The doctor normally requests a blood test to determine the thyroid function (i.e. if your body is producing normal thyroid hormone levels) or look for particular antibodies, however, diagnosing Graves’s Disease during pregnancy can be particularly difficult because of the changes that naturally occur in a woman’s body at the time. There are also shared symptoms like fatigue and heat intolerance which further complicate diagnosis. A test that would allay fears of Graves’ Disease is the radioactive iodine uptake test which gauges how much iodine is used by the thyroid. This test is not recommended during pregnancy because of the radioactive nature.
Does Graves’ Disease Affect the Baby?
It is vital that proper diagnosis and treatment is taken to counter otherwise grievous harm that Graves’ Disease can have on your baby. Some of the major risks include brain development issues, pre-term birth, thyroid problems and low birth weight. The mother is also at risk for preeclampsia, miscarriage or placental abruption. Furthermore, the antibodies that cause this autoimmune disorder can pass through the placenta and harm the baby. The doctor will closely monitor your antibodies levels and the baby to ensure you both stay safe.
Treatment During Pregnancy
Your doctor will refer you to an endocrinologist (hormone-related Disease specialist) who will keep an eye on your thyroid levels. Treatment is dependent on when the symptoms occur i.e. the first trimester or the third trimester. Antithyroid medicine given during the first trimester includes Propylthiouracil which Methimazole is administered for the remainder of the pregnancy period. Beta-blockers may be administered in the first couple of weeks to ease symptoms.
The Inheritance Pattern
It is still unclear how the inheritance pattern works since several genetic and external environmental factors are involved. That said, Graves’ is known to cluster in families and wherever a family member has been diagnosed with Graves’ Disease or any other autoimmune disorder, chances of other family members developing the condition increases.
How Graves’ Disease Affects Your Thyroid
Located in the front of the neck and just below the voice box, is the butterfly-shaped thyroid gland in charge of producing hormones which control metabolism, body growth, and development. The thyroid also plays a key role in the control of the heart rate, emotional state and body temperature.
The thyroid gland produces Diiodothyronine (T2), Triiodothyronine (T3) and Tetraiodothyronine (T4) hormones which work together with other hormones in the body such as estrogen, progesterone, and testosterone.
Any imbalance in the levels of thyroid hormones can have an adverse effect on the body and cause serious health problems such as Graves’ Disease, Hashimoto’s Disease, Hyperthyroidism, and Hypothyroidism. The Graves’ Disease is a leading cause of Hyperthyroidism which causes the immune system to produce antibodies that are similar to TSH (thyroid-stimulating hormones) which then trigger production of hormones in the thyroid.
Persons Affected by Graves’ Disease
The Graves’ Disease and Thyroid Foundation estimates that approximately 2 to 3 percent of the American population is plagued by the Graves’ Disease. This percentage translates to at least 10 Million people living with this condition with several remaining undiagnosed.
Graves’ Disease is detected at the peak of one’s life which is between 20 to 40 years of age. While this condition is known to affect women up to 5 and 10 times more than men, it manifests in a much more severe way in men.
Predisposition to Graves’s Disease is higher in people who suffer from other autoimmune disorders such as
- Lupus. This is a condition whereby the immune system is unable to differentiate between the body’s cells and foreign invaders and ends up attacking its own healthy cells
- Vitiligo. This is a condition caused by the destruction of pigment creating cells or melanocytes and causes the appearance of white patches on the skin
- Rheumatoid Arthritis. This condition targets joints causing pain, swelling, and limitation in movement.
Thyroid Glands Relation to the Eye
In as much the Graves’ Disease and the Graves’ eye Disease are the results of the immune system damaging healthy tissue these Diseases do not stem from each other i.e. having Graves’ Disease does not necessarily instigate Graves eye Disease and vice versa. Each Disease runs its own course and they may not occur at the same time. As such, treatment for one Disease does not mean that the other condition will improve.
Signs and Symptoms of Graves’ Eye Disease
With Graves’ Eye Disease, tissue surrounding the eye is attacked resulting in inflammation and swelling which then causes
- Bulging of the eyes
- Redness and pain
- Puffiness around the eyes
- Dry eye and irritation. This occurs because the eyes have bulged and the eyelids cannot close over them completely
Continued swelling causes
- A deep headache or pressure pain made worse with eye movement
- Excess pressure within the eye socket
- The swollen tissue to push the optic nerve leading to decreased vision
Treatment for Graves’ Disease
People suffering from Graves’ Disease can receive treatment from one of the following methods:
Radioiodine Therapy
This is a common treatment option for Graves’ Disease that involves the intake of radioactive iodine-131 in prescribed doses; usually in the form of pills. The doctor will discuss with you any precautions that need to be taken before this form of treatment commences.
Anti-Thyroid Drugs
Your doctor may prescribe anti-thyroid drugs including Propylthiouracil and Methimazole to treat Graves’ Disease. Beta blockers can also be prescribed to minimize the effects of the symptoms until other treatments start to work.
Thyroid Surgery
Surgery is the least used option when it comes to treatment and is mostly recommended if
- Other forms of treatment have not worked
- A woman is pregnant and is unable to take anti-thyroid drugs
- The doctor suspects you have thyroid cancer
Thyroid surgery may involve complete removal of the thyroid gland in order to eliminate the chance of hyperthyroidism recurring. Thyroid hormone replacement therapy will be required on an ongoing basis if surgery is selected as a treatment option.
It is important to discuss the pros and cons of all the treatment options before settling on a particular course.
The Best Diet for People with Graves’ Disease
While food will not cure the Graves’ Disease, it still plays a big role in managing the condition because certain foods contain nutrients and antioxidants that help ease symptoms while other foods cause flare-ups.
Since the Graves’ Disease triggers the thyroid gland to secrete too much thyroid hormone which then leads to hyperthyroidism, various systems will become visible including:
- Osteoporosis and brittle bones
- Severe weight loss
You will find that certain foods only serve to worsen the situations. Food sensitivities and food allergies can hamper the work of the immune system which in turns causes flare-ups. It is crucial to pinpoint foods that give you allergies and by staying away from them, you will minimize the symptoms.
Foods to Avoid
A dietician will certainly help you identify the foods you should stay away from. In addition to the dietician/doctor’s advice, maintaining a food diary will help you pick out foods that exacerbate your symptoms and those that don’t.
Listed below is a guide on some of the foods that you should consider eliminating from your diet:
Gluten
Gluten laden foods make treatment a little harder for anyone suffering from autoimmune thyroid Disease such as Graves’ Disease. Further, research indicates that there is a high occurrence of Celiac Disease in people suffering from thyroid Disease than in the rest of the population. It is important to go through labels so as to identify any gluten-containing ingredients which may be present in many foods and drinks. Some of the common foods that are high in gluten include:
- Wheat and wheat products
- Triticale
- Barley
- Rye
- Malt
- Brewer’s yeast
- All types of grains such as Spelt, Farro, Durum, and Kamut.
Dietary Iodine
Iodine is a micronutrient necessary and recommended for good health. However, excessive intake of iodine may set off hyperthyroidism in people who are already living with Thyroid Disease. It may also activate hyperthyroidism in older adults. As such, it is important to talk with your doctor about how much iodine you should consume.
Examples of foods that fortified with iron are:
- Dairy products like yogurt, cheese, and milk.
- Bread
- Salt
- There are also foods whose iodine content is naturally high for example:
- Seafood most especially white fish. Examples of white fish are cod and haddock
- Sea vegetables like Kelp and other Seaweed.
Meat and Other Animal Products
There’s a study that proves that people who follow a vegetarian diet have a lower rate of hyperthyroidism compared to their non-vegetarian diet counterparts. This study also found that those who avoided all kinds of animal products which includes chicken, pork, fish, and meat benefited the most
Foods to Eat
Having looked at foods that increase or trigger symptoms related to thyroid Disease and Graves’ Disease, in particular, let’s now look at the foods which contain certain nutrients that work to minimize these symptoms
Foods Rich in Calcium
Presence of hyperthyroidism in the body inhibits the absorption of calcium which can result in brittle bones as well as osteoporosis. A diet that is high in calcium can help alleviate symptoms but it is important to note that there are dairy products which have been fortified with iodine and they may work against your goal.
You can talk to your dietician or doctor about the different dairy products available, more especially which ones you can consume since iodine is needed in your body.
Other foods that are rich in Calcium include:
- Almonds
- Sardines
- Kales
- Broccoli
- Okra
Foods High in Vitamin D
Vitamin D facilitates absorption of calcium from food and is key to your health. Most of this vitamin is manufactured in the skin via absorption of sunlight. Foods high in Vitamin D include:
- Cod liver oil
- Tuna
- Sardines
- Salmon
- Mushrooms
Foods High in Magnesium
A body that deficient in Magnesium is also unable to absorb Calcium. This deficiency also aggravates linked to Graves’ Disease. Examples of foods that contain this mineral include:
- Dark Chocolate
- Almonds
- Cashew nuts
- Brazil nuts
- Avocados
- Pumpkin seeds
- Legumes
Foods Containing Selenium
Selenium is a mineral and an antioxidant found in:
- Brazil nuts
- Sunflower seeds
- Sardines
- Brown rice
- Mushrooms
Deficiency of selenium is linked to thyroid eye Disease in people suffering from Graves’ Disease. This deficiency causes double vision and bulging eyeballs.
Having a diet that is rich in the above-mentioned foods will certainly alleviate the symptoms of Graves’ Disease. It is important to take a keen interest in knowing which foods cause you allergic reactions or flare-up symptoms of Thyroid Disease.
Natural Treatment for Graves’ Disease
As with every other condition, there are natural treatment methods for Graves’ Disease
Manage Stress Levels
Researchers have proven that stress in both humans and animals can stir up autoimmune reactions and even make inflammations worse. This explains why a large percentage of Graves’ Disease patients mention going through chronic stress or traumatic experiences before the onset of the Disease. Research further shows that stress leads to psychological and physical changes which have a bearing on how the immune system operates. It causes a downward change of neuro-endocrine which in the end, lead to tissue damage and autoimmune disorders.
In addition to that, stress may raise the levels of adrenaline and cortisol which then upset neurotransmitter functions and may exacerbate symptoms of Thyroid Disease. It is important to keep stress levels low on a daily basis so as not to worsen Graves’ Disease. You can do this by incorporating certain activities into your schedule as such exercising, praying, meditation, using essential oils, massage therapy, spending time in nature and acupuncture.
Follow an Anti-Inflammatory Diet
Consuming a healthy diet that made up of anti-inflammatory foods helps you to enhance your immunity, manages autoimmune symptoms and builds a healthy gut environment.
Consumption of common allergens such as gluten and dairy products can and will trigger autoimmune reactions from your immune system which will consider these foods as a threat should they not be digested properly.
An unhealthy gut ‘microbiota’ results from nutrient deficiencies and food sensitivities or allergies all of which elevate autoimmune activities and inflammation. Anti-inflammatory foods that are toxins-free will help clear bacterial imbalances in your gut that may worsen symptoms. By incorporating anti-inflammatory foods in your diet, you will be keeping all these issues at bay.
Work Out
Incorporating exercises into your daily routine is a great way to boost morale, make you feel a lot happier, less anxious and improves the quality of your sleep. As long as you are enjoying the exercise, you will be able to keep stress under control and lower inflammation. Some forms of exercises that you can have include swimming, cycling, walking, and dancing. Throwing in your favorite music as you exercising makes it worthwhile as music is known to increase relaxation.
It is important to not over train because this will make you irritable and beat the purpose of training in the first place
Thyroid disorders interfere with your body’s capacity to maintain bone strength because high levels of hormones present in the system inhibit the intake of calcium and other minerals responsible for bone strength. It is vital to incorporate a nutrient-rich diet as you exercise so as to protect your bones from getting brittle.
As you age, you can build on strength training in order to keep your bones strong. Body weight exercises are some of the exercises you can do at home to keep the bones strong.
Stop Smoking
Smoking cigarettes, inhaling cigarette smoke as well as exposure to tobacco and a host of other recreational drugs all have the potential of triggering autoimmune disorders such as Graves’ Disease. While there is no documented report on how cigarettes can worsen Graves’ Disease, it is suspected that the high levels of toxins found in cigarettes (plus other drugs) raise inflammation harm healthy tissue and cells which then triggers the immune system to bring out more T-fighter cells.
Don’t Expose Yourself to Environmental Toxins
In the United States, over 80,000 chemicals and toxins are used legally every year. These chemicals and toxins come in the form of household and beauty products, prescription medicine, antibiotics, birth control pills and chemically-sprayed crops. That can only mean that we all come into contact with these chemicals and other environmental toxins several times on a daily basis be it in the products we use or food we ingest.
I recommend drinking high quality filtered water that is free of chlorine and fluoride, using naturally made household products, buying organic produce and avoiding unnecessary medication or make use of homemade remedies.
Treat Eye and Skin Sensitivity
Graves’ Ophthalmopathy, also referred to as Graves’ orbitopathy is a complication that can arise with the Graves’ Disease. This complication causes a bulging of the eyes, difficulty in seeing, dry and puffy eyes and in some cases creates a sensation of grittiness.
There are simple home remedies that you can try to ease pain and inflammation. Pressing a cold compress against the eyes will keep them moisturized. You can also apply lubricating eye drops to keep the eyes moisturized. Wearing sunglasses when outdoors, shields sensitive eyes from ultraviolet rays which will worsen the damage. Lastly, if you experience puffy eyes when sleeping at night, try elevating your head so as to prevent blood and other fluids from building up round about your face
Applying soothing essential oils combined with coconut oil combats itchiness, reddening and swelling on skin that is affected by Graves’ Disease. Lavender, frankincense, rose and tea tree oils are all examples of gentle essential oils which are also anti-inflammatory.
Discuss Graves’ Disease Complications With Your Doctor
Have a candid discussion about Graves’ Disease and potential for Graves’ Disease as well as complications that arise from this disorder. Left untreated, this disorder opens the door for other complications especially if you are already suffering from another autoimmune disorder or inflammatory Disease or if you are pregnant.
It is important for a pregnant woman to have the Graves’ Disease closely monitored and under control because this disorder poses a greater risk of miscarriage or preterm birth, poor fetal growth, fetal thyroid dysfunction, preeclampsia (high blood pressure) and maternal heart failure. Graves disorder complicates matters for people with a history of heart Disease or heart complications because it can result in alterations in the structure and role of heart muscles, heart rhythm disorders and in rare cases cause heart failure. Further, due to the risk of Osteoporosis (brittle weak bones) following the body’s inability to absorb calcium due to high thyroid hormone levels, it is important to talk about it as well
Conclusion
There is a lot you can do at home to lower the risk of Graves’ Disease or manage its symptoms; however, it’s crucial to obtain professional help anytime you notice a surge or worsening of symptoms. Also, go for professional help if whenever you feel an increase in stress/anxiety levels which can cause a relapse. The good news is that once Graves’ Disease is treated or most of resolved, it leaves no permanent damage and will not lead to other disorders.
