Hyperthyroidism & Graves Disease

Graves Disease

Hyperthyroidism occurs when the thyroid gland produces excessive amounts of T3 and/or T4 resulting in an overactive thyroid. Hyperthyroidism is much less common than hypothyroidism, affecting only about 1% of the population.

T3 is the more active thyroid hormone made up of three molecules of Iodine while T4, made from 4 molecules of iodine is the less active form of thyroid hormone.  T4 is converted to T3 throughout the body in various places including the liver.

Causes of Hyperthyroidism

• Graves‘ disease: inflammatory autoimmune disease in which antibodies stimulate the thyroid to produce excessive thyroid hormone; accounts for most cases of hyperthyroidism
• Toxic nodular goitre: benign tumours in the thyroid which produce excessive thyroid hormone
• Secondary hyperthyroidism: may be caused by factors such as excessive iodine intake, excessive thyroxine intake or tumours of pituitary, testes or ovaries. Risk factors

Risk Factors

• Age between 20 and 40 years
• Stress
• Pregnancy
• Family history of thyroid conditions
• Intestinal permeability
• Bacterial overgrowth of the gut
• Excess antibiotic use

Signs and Symptoms of Hyperthyroidism & Graves Disease

• Tachycardia or palpitations
• Hypertension
• Goitre
• Moist skin and increased perspiration
• Shakiness and tremor
• Nervousness and irritability
• Confusion
• Increased appetite
• Weight loss
• Difficulty sleeping
• Sensitivity to heat
• Exophthalmos and staring
• Altered menses

Differential diagnosis

• Anxiety
• Hyperactivity
• Neurologic disease with resultant tremor
• Heart disease
• Drugs

TREATMENT STRATEGY FOR GRAVES DISEASE

• Regulate immune response
  • Balance gut flora and reduce intestinal permeability
  • Assess / eliminate food allergies and sensitivities
  • Avoid toxic exposure
  • Support proper immune function
• Reduce thyroid hormone output
  • Assess iodine status and reduce iodine intake if high
  • Increase intake of thyroid inhibiting substances
• Reduce inflammation and oxidative stress to the thyroid gland
• Support nervous system / reduce stress

Diet plan guidelines for Graves’ Disease

• Nutrient-dense diet: high in vitamins, minerals, antioxidants and energy-producing co-factors to support the increased metabolic rate
• Assess/eliminate all food sensitivities and intolerances:
  • A gluten-free casein-free (GFCF) diet should be considered in all autoimmune disease.  All possible immune reactive and cross reactive foods should be eliminated, reintroduction of some foods can be trialed at a later date.  I would strongly recommend following an Autoimmune Paleo (AIP) diet with Graves’ disease or just about any other autoimmune condition.
• Anti-inflammatory, antioxidant diet:
  • Emphasise colourful fruit and vegetables, turmeric, ginger, green tea, berries, oily fish, etc.
  • Reduce sugar, refined grains, refined oils, processed foods and animal proteins
• Assess iodine status and reduce intake of iodine if high:
  • Reduce intake of sea vegetables (especially kelp), seafood, spirulina. Replace iodised salt with natural Celtic sea salt.
• Regular intake of dietary goitrogens: raw cruciferous vegetables (e.g. coleslaw), millet, broccoli, catechins from tea
• Include fibre and probiotic foods to support gut flora health

Supplements that support Graves’ disease and Hyperthyroidism

• Acetyl-l-carnitine – : blocks effect of excess thyroid hormone in the tissues, supports energy production in muscles and may help reduce symptoms
• Taurine – : may inhibit thyroid activity and supports heart energy production, stimulates the gall bladder
• Omega-3 EFAs –  reduces inflammation
• B-complex- supports energy production
• Magnesium –  supports energy production and reduces stress response
• Probiotics – balances gut flora and supports immune response – thorough testing of the gut is recommended with any autoimmune disease
• Broad-spectrum antioxidants:
  • Vitamins A, C, E
  • Zinc –  also needed for thyroid function
  • Selenium –  helps lower thyroid antibodies
  • CoQ10 – also helps lower blood pressure and support energy production
  • Alpha-lipoic acid –  helps with insulin sensitivity
• Calcium and vitamin D –  may be needed if bone growth, mineralisation and remodeling are being impacted

Herbal Medicine treatment that supports Graves’ disease

• Reduce thyroid activity – bugleweed, lemon balm
• Immune system modulators – echinacea, astragalus, hemidesmus
• Anti-inflammatory – turmeric, ginger, rehmannia, bupleurum
• nervous system relaxants – passionflower, zizyphus, scullcap, oats, hops
• Reduce palpitations – motherwort (also thought to have anti-thyroid activity)
• Adaptogens – withania, rehmannia

Lifestyle / Physical measures

• Ice packs to the throat will help to decrease inflammation
• Castor oil packs to the throat will reduce inflammation – apply oil directly to the skin, cover with a clean soft cloth and plastic wrap, place a heat source over the pack – leave in place for 30 – 60 minutes

FUNCTIONAL MEDICINE TREATMENT OF GRAVES DISEASE

Graves’ disease is an autoimmune thyroid condition in which the patient’s own cells attack the thyroid gland.  It is a relatively common condition but not as common as Hashimoto’s thyroiditis, another autoimmune condition that results in lower output of the thyroid gland.

Graves’ disease requires a combined approach to assess autoimmune antibodies, viral load, methylation imbalances, key nutrient imbalances including zinc, selenium, iodine and tyrosine.  The approach to Graves disease should be to stop the aggravation of the immune system and slow down the overproduction of the thyroid gland and hormone. 

At our Perth clinic of Advanced Functional Medicine we are very experienced with autoimmune thyroid disorders.  Our patients undertake specialised testing through stool, breath, blood and saliva to give us a clear understanding of how the body is functioning and individualised causes of the immune system attack. 

If you or a family member are suffering from Graves’ disease or another thyroid disorder we would love to hear from you.  Have you had your gut tested and identified foods that are reacting or cross reacting with your immune system?  What treatment are you currently undertaking for Graves’ disease?  Has your overactive thyroid now turned underactive?  Please leave a comment.

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