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Graves’ Disease is the most common cause of hyperthyroidism. It can cause excess thyroid hormone production, weight loss, anxiety, and fatigue.

Keep reading to find out the causes of and treatments for Graves’ disease.

What is Graves’ Disease?

graves' disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474632

Graves’ disease is an autoimmune disease that causes increased activity of the thyroid, which is the small gland in the neck. This results in an enlarged thyroid and high thyroid hormone levels [R].

Graves’ disease is the most common cause of hyperthyroidism in the world, which is an excessive level of thyroid hormones in the body and tissues [R, R].

Graves’ Disease Diagnosis

When doctors diagnose this disease, they usually look at the patient’s’ blood test results. Graves’ disease patients usually have high levels of thyroxine (T4) and triiodothyronine (T3) and undetectable levels of thyroid stimulating hormone (TSH) [R].

When the diagnosis is uncertain, there are additional tests that measure the patient’s’ TSH receptor antibodies (TRAb) and radioactive iodine (RAI) uptake. Or, a thyroid ultrasound with Doppler is used [R].

Graves’ Disease Symptoms

graves disease

https://ghr.nlm.nih.gov/condition/graves-disease

Common symptoms include [R]:

  • Fatigue
  • Anxiety
  • Weight Loss
  • Eye pain and redness
  • Ophthalmopathy (eyeball swelling and protrusion)
  • Dermopathy (skin disease)
  • Difficult breathing
  • Increased heart rate
  • Tremors
  • Thyroid enlargement

Additionally, elderly Graves’ patients with hyperthyroidism can also have heart failure, irregular heartbeat, poor appetite, depression, and weight loss [R].

Meanwhile, women may have irregular periods, hair loss, or neck swelling [R].

Causes and Mechanisms

Immunoglobulins (IgG antibodies) bind to and activate the thyroid stimulating hormone (TSH) receptor on thyroid gland cells. This causes thyroid gland cell growth, which results in an enlarged thyroid and high thyroid hormone levels [R].

Th17 and Th22 cells also play a big role in Graves’ disease development by increasing the autoimmune response [R].

Risk Factors

Various risk factors for Graves’ disease and Graves’ hyperthyroidism include [R, R, R]:

  • Stressful life events
  • Iodine exposure
  • Infections
  • Recent childbirth
  • Family history of Graves’
  • Smoking
  • Other autoimmune disease

Women have a higher risk of getting the disease. Most Graves’ patients get it before 40-60 years old, but every age is susceptible [R].

Additionally, Hepatitis C patients that undergo INF-α treatment have a higher risk of developing Graves’ disease [R].

Graves’ Disease and Other Health Issues

Graves’ Disease and Ophthalmopathy

One main symptom of Graves’ is ophthalmopathy, an eye disease. It causes the eye to protrude and the eyelids to retract and lag when opening or closing. T cells (white blood cells) in the body recognize an antigen (molecule that causes an immune response) in the eyes and release cytokines into the tissue. This leads to swelling and eyeball protrusion [R].

Patients usually have a sandy sensation in their eyes, blurry vision, infrequent blinking, dry eyes, and irritation [R].

Graves’ Disease and Dermopathy

Another characteristic, physical change that Grave’s Disease causes is the development of dermopathy. Dermopathy is a skin condition that causes the skin to become red and thick, resembling that of an orange. Skin lesions also form [R].

Acropachy is a type of dermopathy. It is when the tissues in the hands and feet swell [R].

Graves’ Disease and Pregnancy

In pregnant women with Graves’ disease, the antibodies can cross the placenta and also cause thyroid dysfunction in the fetus [R].

Because Graves’ is an autoimmune disease, it can be problematic during the early stages of pregnancy. However, during pregnancy, the immune system is suppressed and Graves’ can improve [R].

If hyperthyroidism and Graves’ is unmanaged, it can cause problems such as [R]:

Graves’ Disease and Cancer

Graves’ disease patients have a higher risk for cancer than healthy people. In a meta-analysis of 33 studies, Graves’ patients had double the risk of getting thyroid cancer [R].

Additionally, in a cohort study of 25,000 patients, the Graves’ patients had a higher risk of having head and neck, liver, breast, prostate, and thyroid cancer [R].

Graves’ Disease and Hashimoto’s Thyroiditis

Unlike Graves’, Hashimoto’s occurs when an antibody blocks TSH hormone activity and causes damage to the thyroid gland.

After discontinuing antithyroid treatment for 5-10 years, 15-20% of patients that recover from Graves’ can develop hypothyroidism due to Hashimoto’s. Although the exact cause is unknown, researchers think that antithyroid medication can contribute to abnormal thyroid hormone levels [R].

Graves’ Disease and Other Autoimmune Diseases

Graves’ disease is associated with a higher risk of other autoimmune diseases. In a study (cross-sectional) of 3200 UK thyroid patients, 9.6% of the Graves’ disease patients had another autoimmune disorder [R].

People with Grave’s can also have [R]:

Graves’ Disease and Myasthenia Gravis

Although Graves’ and myasthenia gravis are both autoimmune diseases, it is rare to have these two diseases at the same time. Both disease may have the same mechanism involving Th17 cells [R].

Treatment Options

https://www.nature.com/articles/nrendo.2013.193

Natural Treatments

Supplements that Decrease Thyroid Hormone Levels

There are many natural supplements you can take to lower your thyroid hormone levels. They include:

Ahnjeonbaekho-tang (AJBHT)

AJBHT is a herbal remedy that contains 8 medicinal herbs that help aid thyroid function. These herbs include kudzu, Chinese skullcap, gypsum, platycodon, Angelica tenuissima, Chinese cimicifuga, fragrant angelica, and Chinese licorice [R].

In a study (clinical trial) of 22 Graves’ patients, AJBHT reduced T3 and T4 levels while it increased TSH [R].

Additionally, because of a lack of side effects, AJBHT is a good alternative to medication and anti-thyroid drugs that can cause other health problems [R].

Pharmaceutical Treatments

1) Antithyroid Medications (Thionamides)

Propylthiouracil (PTU) and methimazole (MMI) are two antithyroid medications that help treat Graves’. They block the production of thyroid hormones. Doctors usually recommend antithyroid medication as the primary treatment for Graves’ disease [R].

However, since it mainly inhibits thyroid hormone production and does not address the cause of the disease, patients can experience a high rate of disease recurrence [R].

Patients take 15-30 mg of MMI once daily, and the dosage can be lowered to as little as 5 mg. Although it can cause liver and bile problems, it is more effective and has fewer side effects than PTU [R].

Meanwhile, patients usually take 50-150 mg of PTU 3-4 times daily. PTU can potentially cause hepatitis and liver failure [R].

While antithyroid medications are generally well-tolerated, their side effects also include stomach problems, muscle pain, and rashes. They might also cause agranulocytosis, or extremely low white blood cell count [R].

Thionamides in Combination with Supplements

Selenium helps with normal thyroid function, and selenium supplementation can enhance the effects of antithyroid medication. In a study (CT) of 41 Graves’ patients, the group that received selenium supplementation had lower T3 and T4 levels, as well as higher TSH levels than the control group [R].

A combination of MMI and a traditional Chinese medicine, Yingliu, may also improve MMI’s effects. Yingliu contains Astragalus and Anemarrhena roots and Prunella vulgaris [R].

In a study (RCT) of 92 Graves’ disease patients, the patients who also took Yingliu in addition to MMI had lower T3 and T4 levels and higher TSH levels than the patients who only took MMI antithyroid medication [R].

2) Potassium Iodide

Potassium Iodide can be used in addition to antithyroid medication or by itself to treat Graves’. When used in combination with antithyroid medication, it may reduce side effects [R, R].

3) Beta-blockers

Beta-blockers are drugs that help reduce high blood pressure or treat heart problems. Using beta-blockers can help rapidly relieve some hyperthyroid symptoms, such as increased heart rate. However, they have no effect on thyroid hormone levels [R].

4) Glucocorticoids

Glucocorticoids are drugs that can stop inflammation. They can reduce thyroid hormone secretion in Graves’ patients. However, it is uncertain how effective they are in treating hyperthyroidism [R].

5) Rituximab

Rituximab is an anticancer drug that may help reduce thyroid eye disease. In a study (CT) of 20 Graves’ patients, it helped prevent hyperthyroid relapse and reduced eye disease symptoms. However, due to its high cost, side effects, and low effectiveness, it is not a good treatment option [R].

Radioactive Iodine (RAI) Therapy

Radioactive Iodine (RAI) therapy uses radioactive iodine (I-131) and can either be used after antithyroid medication or as the initial treatment for Graves’ and hyperthyroidism. RAI treats hyperthyroidism by destroying enough thyroid tissue to lower thyroid hormone levels [R, R].

RAI doses differ for each patient, and can differ for each treatment. However, a fixed RAI dose is associated with better response rates [R, R].

Although RAI is relatively safe, pregnant women should not undergo RAI because it can damage the fetus. Additionally, RAI may increase the risk for heart problems, hypothyroidism (low thyroid hormone levels), and cancer [R].

Thyroid Removal Surgery

Doctors usually recommend removing the thyroid or parts of the thyroid (thyroidectomy) if the other treatments were unsuccessful, unsafe, or if the patient cannot undergo other treatments. Additionally, removing the thyroid can provide quick results in comparison to other therapies [R].

Pregnant women can undergo thyroid removal surgery to prevent damage to their fetus from antithyroid medication or RAI [R].

Patients who undergo thyroid removal surgery for Graves’ disease have a risk for bleeding and nerve injury. They are also at risk for hypothyroidism (low thyroid hormone levels) after the procedure [R, R].

Other Potential Treatments

Although these new treatments are promising alternatives to the three main therapies, no human clinical trials are available.

Human Monoclonal Autoantibodies

Monoclonal antibodies (Mabs) are made in laboratories from human immune cells and can help detect and/or stop harmful antibodies. One Mab, 5C9 IgG, can block thyroid-stimulating antibodies. 5C9 may be able to prevent TSH activity during Graves’ disease [R].

Small Molecule Antagonists

Various small molecules can act as antagonists and block TSHR (thyroid stimulating hormone receptor) activity. In human cells, NCGC00229600 and NCGC00161856 successfully blocked the TSHR [R, R].

Graves’ Disease and Genes/SNPs

A combination of environmental and genetic factors affect a person’s risk for Graves’ disease. If you have a close relative with Graves’, then you have a higher chance of getting the disease [R].

The HLA genes play an especially important role in the probability of getting Graves’. Although the exact genes are unknown, some variants that have a positive association with Graves’ disease risk include DRB1*03 (in Whites and Blacks) and DPB1 (in Asians) [R].

The following SNPs and genes are also associated with a higher risk for Graves’ [R, R]:

Patient Experiences

Many patients comment that they were diagnosed a long time after showing symptoms of the disease. It is important that you see a doctor when you start exhibiting symptoms to ensure prompt treatment.

Their treatment experiences varied. Some people recovered from the disease through RAI therapy. Meanwhile, others saw benefits from thyroid removal surgery or antithyroid medication.

FDA Compliance

The information on this website has not been evaluated by the Food & Drug Administration or any other medical body. We do not aim to diagnose, treat, cure or prevent any illness or disease. Information is shared for educational purposes only. You must consult your doctor before acting on any content on this website, especially if you are pregnant, nursing, taking medication, or have a medical condition.

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6 COMMENTS

  • Tom

    Thanks for this article.

  • Sandy

    Thanks Helen for your comments. I will check with my Chinese Acupuncture lady.

  • Sandy

    I have Hyperthyroid and I was excited to see an herbal mentioned in the above article that helps correct this problem, the Ahnjeonbaekho-tang (AJBHT) . I find out on line that this is a Koren supplement and I am very frustrated to find out there is no place to purchase it and Joe gives us no idea where to purchase it either. Does any one have any idea?

    Then you Abdulrahman claim there is a cure for this, but fail to mention it. This makes me sad indeed.

    1. Helen

      Sorry, but it is not available for purchase online. You would have to go to a herbal shop or find oriental herbalists to buy the mixture from.

  • Kay

    Graves’ Disease can be deadly and cannot be treated naturally alone. I am personally not a supporter of radioactive iodine treatment either. Yes, taking a medication like methimazole may seem like a slow process, but those who have radioactive iodine are likely to face years of medication adjustments as well. Also, just because you kill your thyroid doesn’t mean you don’t still have Graves’ Disease (antibodies still exist). So you will likely be dealing with the effects of both.
    I would encourage anyone dealing with this terrible illness to try medication first (likely to take 2-3 years to reach remission) and only as a last result consider thyroidectomy. I also encourage you to not treat this disease naturally either as you can easily slip into thyroid storm and die. It is a serious illness! Yes, support yourself nutritionally, avoid iodine in foods (dairy, seaweed, shrimp, most multivitamins,etc.) take supplements that help you heal like vitamin D and iron, but don’t think that is sufficient treatment. You need medical intervention. I know this personally!
    If your eyes are bothering you, call around until you find an ophthalmologist who is familiar with Graves’ and have frequent appointments (another huge reason to avoid radioactive iodine–it can make the eye disease much worse). Graves’ is serious and not something to try to heal on your own. Also, don’t be discouraged in trying to find the right endocrinologist. This can be challenging, but keep trying! There is also a very good Facebook group called “Keeping Your Thyroid”. Good luck all!

  • Abdulrahman

    Hello Joseph,

    This time I’m disappointed. You are trying to cover many diseases in a short time, but then with insufficient focus you are not able to produce a reliable natural solution or treatment that works well. So with little time available you primarily exhibited the standard medical treatments for Grave Disease.

    These treatments are all dangerous as they inhibit Thyroid cell activity through chemical means in general, and even worse, the Radioactive Iodine kills activity by irradiating the cells after they uptake the iodine from bloodstream. The Mitochondria is mostly killed, leaving the cells unable to produce sufficient Thyroid Hormones and the patient is forced to use Thyroid tablets for the remainder of their lives.

    A short time later, meaning a few years later, many of these patients then contract Thyroid Cancer due to the radiation treatment. But that’s no problem, the specialty cancer clinics are happy to treat these new patients as needed. Barbaric treatments are the norm with “Modern Medical Science”.

    There is a Natural Cure that directly addresses the root causes of Graves Disease and you and others with similar intellectual capabilities have the ability to find that and achieve a cure, not only treatment, without damaging thyroids cells.

    Thank you,

    Abdulrahman

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