Thyroid disorders are on the rise in the western world, yet hyperthyroidism and Graves’ disease remain among the most rare forms of thyroid illness.
While underactive thyroid or hypothyroidism and Hashimoto’s thyroiditis often take centre stage, an overactive thyroid can be just as debilitating.
Getting an accurate diagnosis of Graves’ Disease can also be a long and stressful process, delaying treatment and prolonging uncomfortable symptoms and unnecessary suffering.
Conventional treatment can often fall short of addressing the underlying factors, or achieving full resolution of symptoms.
In this article, we take a deeper look at the functional medicine approach and natural treatment options for Graves’ Disease and hyperthyroidism.
What is hyperthyroidism and Graves' Disease?
Hyperthyroidism is the term given to an overactive thyroid, which causes the butterfly-shaped gland in the front of the neck to make more thyroid hormones than the body requires. This results in other functions in the body speeding up, including the way the body uses energy. As a result, people often experience weight loss and difficulty gaining or maintaining weight, even when eating more. Hyperthyroidism is most commonly caused by Graves’ Disease, an autoimmune thyroid disorder that causes the body to produce antibodies that over-stimulate the thyroid gland.
Graves’ disease is most common in people aged between 30 and 50, but can occur at any age, and is up to eight times more common in women than men. People with pre-existing autoimmune disorders, including rheumatoid arthritis, pernicious anaemia, lupus, Addison’s disease, coeliac disease, vitiligo, and Type I diabetes, are also more likely to develop Graves’ disease than those without. In fact, around 25% of people with an autoimmune condition tend to develop three or more autoimmune conditions, likely due to a combination of genetic and environmental factors.
A family history of Graves’ disease also increases the risk of developing Graves’ disease further.
Subclinical hyperthyroidism can occur when a person is experiencing symptoms of hyperthyroidism, yet standard thyroid pathology results are not indicative of hyperthyroidism. Specifically, subclinical hyperthyroidism can be defined as low or undetectable TSH, with normal free thyroxine (T4) and total triiodothyronine (T3) levels.
Signs and symptoms of hyperthyroidism and Graves’ disease
Symptoms of hyperthyroidism may not develop until advanced stages of Graves’ disease, or may be overlooked or misdiagnosed.
People with hyperthyroidism and Graves’ may experience just one, some, or all of the following symptoms:
- Hair loss
- Bulging eyes
- Enlarged thyroid (goiter)
- Rapid heart rate or palpitations
- Weight loss, difficulty gaining weight
- Frequent bowel movements
- Thickened skin on shins or feet
- Warm moist palms
- Trembling hands
- Soft nails
- Difficulty sleeping
- Heat intolerance
- Miscarriage and pregnancy complications
- Muscle weakness
- Nervousness and anxiety
- Scant menstrual periods
Left untreated, hyperthyroidism and Graves’ disease may lead to:
- Irregular heartbeat leading to blood clots, stroke, heart failure, and other heart conditions
- Graves’ ophthalmopathy, an eye disease causing double vision, light sensitivity, eye pain, vision loss
- Thinning bones and osteoporosis
Root causes and contributing factors of hyperthyroidism and Graves' disease
Hyperthyroidism primarily occurs as a result of Graves’ disease, but can have several other potential causes too.
Graves’ disease: The most common cause of hyperthyroidism which causes the immune system to enlarge the thyroid and overstimulate hormone production.
Thyroid nodules: Benign lumps in the thyroid that become overactive and produce too much thyroid hormone, more common in older adults.
Thyroiditis: Inflammation of the thyroid which causes stored thyroid hormone to leak from the gland. This form of hyperthyroidism is usually short term, and followed by hypothyroidism.
Subacute thyroiditis: Causes painful inflammation of the gland, which may be triggered by an underlying infection or virus.
Postpartum thyroiditis: A form of thyroiditis triggered by hormonal and autoimmune disruption after pregnancy and birth.
Silent thyroiditis: Painless inflammation of the thyroid, likely autoimmune related.
Pituitary tumour: In rare cases, hyperthyroidism may be caused by a non-cancerous tumor on the pituitary gland, at the base of the brain.
Iodine overconsumption: The thyroid uses iodine to make thyroid hormones. In some people, consuming large amounts of iodine in iodised salt, seaweed, and processed food may disrupt hormone production.
Thyroid medication: Thyroid stimulating hormone medicine for hypothyroidism can sometimes lead to an overcorrection.
Underlying infections or toxicity: underlying infections like the Epstein-Barr or herpes viruses, and toxicity of pollutants like heavy metals like mercury, have also been shown to contribute or cause thyroid and immune system dysfunction.
Intestinal Hyperpermeability: Having a more permeable intestinal tract, commonly known as ‘leaky gut’, can expose the body to undigested food particles, microbes, and toxins that can cause inflammation which can lead to autoimmunity.
Common and conventional treatments for hyperthyroidism and Graves’ disease
Early diagnosis and intervention are essential to avoid adverse effects on the heart, eyes and bone structure, which makes it important to consult with a practitioner experienced in the diagnosis and treatment of hyperthyroidism.
However, diagnosing hyperthyroidism and Graves’ disease can sometimes be challenging.
Presentation of the symptoms described above can raise suspicion of an overactive thyroid, and several testing options are available to confirm a hyperthyroid diagnosis.
Blood tests can be used to assess thyroid hormone and antibody levels, however, this isn’t always an effective method in mild cases. Imaging tests can also be used to analyse iodine uptake, including a radioactive iodine uptake test, and thyroid ultrasound.
Conventional treatments include antithyroid medication, which achieves remission within a year for 50 percent of patients. If remission isn’t achieved, or a relapse occurs, a thyroidectomy (removal of the thyroid gland) or radioactive iodine treatment may be explored.
The Melbourne Functional Medicine Approach to hyperthyroidism and Graves’ disease
There is a common underlying factor to each of the causes and contributors to an overactive thyroid, and that is inflammation and immune dysregulation. While simply addressing inflammation is not sufficient for treating hyperthyroidism, it is often the first step to regaining control of autoimmune disorders.
Patients often come to Melbourne Functional Medicine with an aim to get off or avoid medication and surgery. Our practitioners approach hyperthyroidism and Graves’ disease with a more holistic, proactive, and preventative approach.
Just some of the ways our practitioners can support your journey with hyperthyroid recovery include:
Optimise nutrition: Nutrition and diet for hyperthyroidism is about much more than just eating to gain weight. The foods we eat can either help or hinder autoimmune disorders and thyroid conditions, and our practitioners work with each individual to find the right foods, and supplements, for them.
Amy Myers MD, author of The Autoimmune Solution and The Thyroid Connection recommends people with hyperthyroidism and Graves’ disease:
- Remove gluten, grains and lentils: Gluten-containing grains like wheat also contain amylase-trypsin inhibitors which are plant-derived proteins that naturally protect plants from insects. These proteins, like lectins in legumes, have been shown to trigger an inflammatory immune response in the gut that can spread to other parts of the body. For this reason, removing gluten, grains and lentils may help to reduce the system inflammation typical of hyperthyroidism.
- Avoid caffeine, alcohol and iodine: Caffeine and alcohol can aggravate symptoms such as anxiety and rapid heart rate that people with hyperthyroidism experience, while foods high in iodine such as iodised salt and seaweed may worsen the condition.
- Increase minerals and vitamins: People with hyperthyroidism may develop nutritional deficiencies resulting from inflammation and immune system overdrive. While multivitamins are popular, they’re not all created equal. Our practitioners work with each patient to create a nutritional protocol unique to their needs, which may include thyroid and immune-supporting vitamins and minerals like Vitamin C, vitamin E, selenium, zinc, L-carnitine and CoQ10.
Improve gut health: Reducing inflammation naturally improves digestion and nutrient absorption, although gut health can be further supported with the right proactive approach. Our practitioners can select from a range of probiotics, herbs, and supplements to quell inflammation and improve the digestive system’s ability to absorb nutrients from food, which is especially important for people with unwanted weight loss.
Support immune health: Our practitioners use functional testing to determine the best ways to support each patient’s immune health. A combination of Vitamin D, omega 3, and glutathione can combine as powerful immune modulators that may help to regulate immune function, quell inflammation and improve detoxification for people with hyperthyroidism.
Remove heavy metals and systemic infections: We are exposed to a wide range of sources of heavy metals and other toxins that can harm the thyroid, including contaminated water supply, soil, amalgam fillings, fish, pollution, body products, and the general environment. Chronic underlying infections like Epstein-Barr virus and Ross River fever can also have a damaging impact on immune and thyroid health. Our practitioners can work with you to identify any of these potential issues, reduce your exposure to toxins and address any underlying damage.
These are just some of the ways our practitioners can support people with hyperthyroidism and Graves’ disease at Melbourne Functional Medicine. The approach for you may be different depending on your individual findings. Self-diagnosis and treatment of hyperthyroidism are not recommended due to the serious nature of long-term thyroid damage.
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