Have or someone you know been diagnosed with Graves’ disease? Are you wondering what this condition is, what it means and where to from here?

As a naturopath specialising in thyroid disorders, many of my patients have thyroid issues such as Hashimoto’s hypothyroidism, thyroid nodules, Graves’ disease or a history of thyroid cancer. For many of these patients, learning more about their condition gives them a greater sense of control and autonomy over their health, allowing them to communicate with health professionals and play a more active role in the management of their condition.

Following my Hashimoto’s series, I’ve had many requests for a similar series of blog posts exploring Graves’ disease. This is the first instalment in the series, so make sure to sign up to my newsletter to be notified of new additions as they’re released.

What is Graves’ Disease?

Like Hashimoto’s, Graves’ disease is an autoimmune condition in which the immune system mistakenly targets the thyroid gland. In Graves’ disease, the immune system produces cells known as “TSH receptor antibodies”, which bind to receptors on the thyroid gland and stimulate it to produce thyroid hormones. As a result, excessive amounts of thyroid hormones are released into the blood, resulting in ‘hyperthyroidism’ (aka, an overactive thyroid).

Symptoms can include anxiety and nervousness, weight loss, hot flushes, night sweats, increased appetite, difficulty sleeping, hair loss, diarrhoea, menstrual irregularities, heart palpitations, erectile dysfunction and more. Some individuals will also present with eye symptoms, such as sore, red or irritated eyes, light sensitivity, blurriness or bulging eyes.

What Causes Graves’ Disease?

Whilst there is no single identifiable cause of Graves’ disease, it is believed a combination of genetic and environmental factors may play a role.

Researchers have identified a multitude of factors which can increase your risk of developing the condition, which include:

Being female (Graves’ disease is 7-8 times more common in women than men)
Being 30-50 years old
Recent pregnancy
Having a family history of Graves’ disease or autoimmune thyroid disorders
Smoking
Emotional or physical stress (many Graves’ patients report a period of increased stress in the year prior to their diagnosis)
The presence of other autoimmune diseases (such as type 1 diabetes or rheumatoid arthritis)
A history of certain infections (such as Epstein-Barr virus, also known as glandular fever)

Is Graves’ Disease the Same as Hyperthyroidism?

Hyperthyroidism refers to an overactive thyroid gland. Graves’ disease is the most common cause of hyperthyroidism, but other conditions (such as toxic multinodular goitre) can also cause hyperthyroidism.

How is Graves’ Disease Diagnosed?

Graves’ disease is usually diagnosed via a blood test. A typical confirmatory test will reveal the presence of TSH-receptor antibodies, and in the case of autoimmune hyperthyroidism, a low TSH and elevated levels of thyroid hormones as well.

Occasionally, a healthcare provider may order further investigations as well, such as additional blood tests, a thyroid ultrasound and/or a radioactive iodine uptake test.

How is Graves’ Disease Treated Medically?

There a number of options for managing Graves’ disease medically and/or surgically, and your prescribed treatment will depend on factors such as your age, the severity of your condition and other relevant factors such as whether you are pregnant or hoping to conceive in the near future.

For example, anti-thyroid drugs are a common medical approach to managing hyperthyroidism. These medications include drugs such as Methimazole and Propylthiouracil, which work to reduce thyroid hormone production. Whilst they’re not considered a ‘cure’, they may be prescribed for a certain amount of time before a ‘weaning period’ is commenced. Unfortunately for some patients treated with anti-thyroid drugs, relapses will occur. Other, more ‘permanent’ solutions include radioactive iodine therapy (which destroys the thyroid tissue) and thyroidectomy (removal of the thyroid gland). If the thyroid is removed, the patient will need to take lifelong thyroid hormone replacement therapy, to replace the hormones usually supplied by the thyroid.

How Can Naturopathy Assist in the Management of Graves’ Disease?

As a naturopath, I work with many patients with Graves’ disease to help them manage their symptoms, regulate immune system dysfunction, dampen underlying autoimmunity and minimise the risk of relapse. Importantly, we work to identify and address factors that might be exacerbating their condition, in addition to addressing the increased levels of inflammation and oxidative stress associated with hyperthyroidism.

As Graves’ disease is associated with an increased metabolic rate (and thus, increased nutritional requirements), I also work with my Graves’ patients to ensure they are nutritionally replete. This is particularly important as unmanaged Graves’ disease is associated with increased risk of osteoporosis and cardiovascular disease longterm, so adequate attention must be given to an individual’s nutritional wellbeing during this time.

Importantly, naturopathic and nutritional medicine can serve as a wonderful adjunct to the medical treatment of Graves’ disease. In many cases, my patients have been able to reduce their dose requirements of antithyroid medications (with the support of their doctor), or have been able to maintain ongoing periods of remission following the cessation of such medications. I also work with Graves’ patients who have undergone radioactive iodine therapy or thyroidectomy, to ensure optimal thyroid hormone levels post-procedure and to promote long-term health and wellbeing.

Naturopathically, there are many tools at our disposal that have been researched for the positive role they may play in the management of Graves’ disease and its complications. These include nutrients such as selenium, vitamin E and carnitine, as well as certain herbal medicines which have been shown to exert immune-regulating and/or thyroid suppressing effects. As always, prior to commencing any form of supplementation, it is important to work with a suitably-qualified healthcare provider to ensure any prescribed supplements are appropriate and safe for your situation.

As interest in holistic and complementary medicine grows, we are fortunate to have an ever-expanding body of research to draw upon demonstrating the extensive benefits of nutritional and herbal medicines in Graves’ disease and hyperthyroidism. Although they are not a ‘cure’, nutritional and herbal medicines have shown promise with regards to improving symptom control, reducing thyroid antibodies, correcting nutritional deficiencies, reducing oxidative stress and minimising the risk of complications such as relapses and Graves’ ophthalmopathy. This is why I am such a big advocate of a holistic and integrative approach to the management of Grave’s disease - It is an incredibly rewarding part of my role helping patients with Graves’ manage their symptoms, keep their condition at bay and correct potential nutritional issues that can arise with hyperthyroidism.

What Next?

I hope this article has been helpful and has improved your understanding of Graves’ disease in some way. If someone you know has been diagnosed with Graves’ disease, please feel free to share this article with them, and stay tuned for my next instalments on the topic. Alternatively, if you’re interested in how naturopathy could help you in the holistic management of a thyroid condition, why not make an appointment or get in touch via my website.

Niki x