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Is It Possible To Reverse Graves’ Disease?

Over prolonged periods of time, without corrected hormone levels, Graves’ disease can lead to heart, bone, and eye issues. In 95% of people, though, Graves’ can be reversed and become a thing of the past. Let’s explore what that means for you today.

Graves’ Disease Today

Hyperthyroidism is prevalent in about 1.2% of the US population, with Graves’ disease being the most common cause1. Graves’ disease is an autoimmune process in which the immune system attacks the thyroid gland and causes it to overproduce thyroid hormones.

Overproduction of thyroid hormones can cause a lot of damage in the body and cause symptoms of:

  • Anxiety
  • Weight loss
  • Heart palpitations
  • Nervousness

Key Insight: When properly treated, Graves’ is a self-limiting disease that usually takes 18-24 months to overcome (1).

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Although there are a number of conventional treatment options for Graves’ disease, natural options should also be considered to help the outcome and symptoms of this disease be better managed. It can be reversible and surgery may be avoided in certain circumstances.

Graves’ Eye Disease

Graves’ eye disease occurs because the eyes contain tissues that appear similar to thyroid tissue and the immune system creates an attack. This causes the eyes to become enlarged or bulge.

The immune system affects the cells in the eyes and causes them to differentiate into fat cells which cause the eyes to inflame2. In a recent study, high cholesterol levels, specifically LDL (low-density lipoprotein) was shown to be a risk factor for Graves’ eye disease3.

Another study looked at using statin therapy to reduce the risk of Graves’ eye disease in Graves’ patients4. In this instance, statins were used for anti-inflammatory benefits.

There are many other treatment options that also have anti-inflammatory and lipid-lowering benefits, so why not address the entire body and look for the root causes of inflammation to see if it can be done naturally?

Key Insight: It is important to look for the root causes of disease so that one can maximize the chances of faster disease reversal. A poor gastrointestinal function has been shown to be a root cause of disease.

There is a growing amount of literature that supports that a connection between autoimmunity diseases and the gut microbiome. An experimental mice study from 2018 showed that when the gut microbiota was altered, this influenced genetics and the immune system which caused a change in antibody level5.

Bottom Line: Thyroid hormones influence almost every tissue and organ in the body, therefore, it is essential that a comprehensive approach is taken to help improve the outcomes of Graves’ disease.

Although someone may present with Graves’ disease, Graves’ Eye Disease is a separate autoimmune condition that runs its own separate course. These diseases can occur at different times and when one disease improves, it may or may not improve the outcome of the other. Symptoms of Graves’ eye disease include:

  • Redness
  • Swelling
  • Bulging of eyes
  • Dry eyes
  • Pressure around eyes
  • Decreased vision

Treatment Options for Graves’ Disease

In general, there is no consensus in what medical treatment options improve the quality of life in patients with Graves’ disease. The general medical treatment options include:

  • Anti-thyroid medication
  • Radioactive iodine (RAI)
  • Surgery6

A recent group of researchers from New Zealand conducted a study to assess for quality of life following a form of one of the above treatments (anti-thyroid medications, RAI or surgery) for Graves’.

Conclusions from the study showed that there was no significant difference in patient satisfaction based on what treatment they had. What is missing, in the context of treatment, is the focus on the root causes of disease and need to include complementary treatments that can also benefit Graves’.

In clinical experience, when addressing root causes and treating the whole body, patient satisfaction seems to increase when a comprehensive treatment plan is recommended. The limitations are due to a lack of research that demonstrates the potential of natural and alternative options in the treatment of Graves’.

Before any treatment is initiated, it is extremely important that patients with hyperthyroid symptoms need an appropriate workup that includes a detailed physical exam which includes:

  • Assessing for pulse
  • Blood pressure
  • Respiratory rate
  • Body weight
  • Thyroid exam
  • Pulmonary, cardiac and neuromuscular function
  • Laboratory analysis of thyroid hormones7

Anti-Thyroid Medications

The first line of therapy for Graves’ disease is usually starting on an anti-thyroid medication, such as a thioamide like propylthiouracil or methimazole, and a beta blocker.

This therapy is usually recommended for up to 2 years, but the goal of treatment is that euthyroid (normal thyroid function) should be achieved in 3 to 8 weeks.

There are contraindications to using these medications in patients with liver disease and low neutrophil (a white blood cell) counts.

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There is also a large side effect profile with these medications such as:

  • Itchiness
  • Rash
  • Hives
  • Joint pain
  • Arthritis
  • Fever
  • Abnormal taste sensation
  • Nausea
  • Vomiting

This can be found in up to 13 percent of patients8. It is important to help restore euthyroid so that severe symptoms of Graves’ can be alleviated and using a multifactorial approach could help the overall course of disease achieve remission at a quicker pace.

Natural Anti-Thyroid Alternatives

The effect of natural supplements such as L-Carnitine on hyperthyroidism has been known since 1950. In a randomized, double-blind, placebo-controlled study from 2004, L-Carnitine was shown to decrease the amount of thyroid hormone that binds with thyroid receptors and that it had an antagonistic relationship to thyroid hormones9.

The study was designed to see if L- Carnitine had a prophylactic and curative role in hyperthyroid related osteoporosis. It is known that hyperthyroidism can lead to carnitine deficiency, using this in clinical settings will improve outcomes but this treatment is typically not suggested as apart of standard care.

Chinese Herbal medicines have also been studied in hyperthyroidism. A Cochrane systematic review of the literature reviewed 13 trials and found that Chinese medicine herbs, when added to routine treatments, had a therapeutic potential for patients suffering from hyperthyroidism, however, no study was completed as the sole treatment option and there is not one single preparation or formula that was found to be the most effective10.

Herbal plant extracts such as Lycopus, Melissa Officinalis and Lithospermum officinale have been known for containing anti-thyroid properties. They have been shown to have the ability to inhibit thyroid hormones but are not consistently effective11.

Other natural treatments such as antioxidants such as N-acetyl cysteine and melatonin have been used in Graves’ disease and have been helpful in reducing oxidative stress that occurs with the disease12. However, they do not reverse the disease by themselves.

Future research should be designed to compare natural versus traditional medications to see if they can help patients suffering from Graves’ with symptom management, remission of disease and overall quality of life. More practitioners should be trained in using integrative treatments so that all patients can benefit from an ideal treatment plan.

Bottom Line: At Integrative Health, we create personal plans to treat Graves’ disease using natural iodine blockers and by addressing the causes of autoimmunity. Learn more about your best approach to Graves’ disease today (2).

Radioactive Iodine (RAI)

This is also a treatment option for patients with mild hyperthyroid symptoms and no eye disease. It is less complicated than surgery, however, it is a permanent ablation to the thyroid gland and irreversible.

It also has the risk of worsening Graves’ eye disease. This treatment is usually administered with an oral capsule of sodium iodine. Studies show that there is some link with this radiation treatment option and increased risk for leukemia, especially when the amount of radioactive iodine exceeds 600 mCi13.

The majority of this iodine is taken up by the thyroid gland, however, it can also be taken by the salivary glands and stomach, causing some adverse effects such as:

  • Dry mouth
  • Nausea
  • Vomiting
  • Infection
  • Dysfunction of the saliva gland

Graves’ Thyroid Surgery

There are indications for surgery such as malignancy, large nodules that cause major thyroid symptoms and in a few cases of thyrotoxicosis14.

In other cases, surgery can sometimes be prevented. The surgery itself can have risks such as damage to the parathyroid gland, which can impair calcium levels, damage to the laryngeal nerve, which can impair speech and swallowing.

Bottom Line: Post thyroid surgery, patients will need to start and be monitored for thyroid hormone replacement therapy for the rest of their lives.

Case Study and Overview

A 33-year-old female was referred to my care back in December 2016 for a diagnosis of Graves’ disease. She was diagnosed 3 weeks prior to coming in for her first new patient visit.

She had symptoms of heart racing, anxiety, weight loss and eyes that were bulging. Her resting heart rate was 116 beats per minute (normal is 60-100). She had seen her endocrinologist and was given a prescription for a heart medication to help her control palpitations and thyroid medication to help decrease the amount of thyroid hormone being released.

Her endocrinologist had also suggested radiation immediately but she resisted and was nervous about this and began to seek out alternative options. At the first office visit, she was educated about Graves’ disease and natural treatments that have been effective at reducing symptoms and supporting the immune system to seek remission of the disease course.

Lab testing was done in detail and looked for rooted causes that could have potentially given rise to the autoimmune condition. Examples of testing included cortisol analysis, food sensitivity testing, stool microbiology testing and screening for toxin exposures (3).

In-depth imaging was also recommended such as a thyroid and heart ultrasound, a screening bone density test and an eye examination to establish baseline measures.

Her treatment plan included:

  • Supplements
  • Immune support
  • Lifestyle changes in diet, exercise, and sleep

Since her first appointment, we continued to have periodic follow-up appointments to carefully screen her thyroid lab results, check in with lifestyle changes and at her most recent follow-up July 2018, she actually discontinued all prescription thyroid medications and is maintaining her hormone levels naturally!

We continue to help her optimize her health by working on her digestive concerns and focus attention to root causes versus symptom management. Overall, she has been extremely happy that she got to keep her thyroid gland!

Reverse Graves’ Today

Are you looking for a safe, all-natural solution that’s been clinically proven to reduce or eliminate the symptoms of Graves’ disease, without harmful drugs or painful surgery? You have come to the right place.

To learn more and get started toward ending the struggles of Graves’ disease, starting today, please visit Integrative Health (4).

Before quickly deciding on a treatment option, speak to your doctor about taking a comprehensive treatment approach that not only looks to improve the disease outcome but also focusing on improving your overall quality of life.

Stop suffering. Graves’ disease is reversible for most and we can help. Contact us today to schedule your free 15-minute consultation to see if we are able to help you manage your thyroid.

1. Singer PA, Cooper DS, Levy EG, Ladenson PW, Braverman LE, Daniels G, Greenspan FS, McDougall IR, Nikolai TF 1995 Treatment guidelines for patients with hyperthyroidism and hypothyroidism. Standards of Care Committee, American Thyroid Association. JAMA 273:808-812.
2. Altunbaş, R., Eren, M., Altıparmak, İ., Karaaslan, H., & Sabuncu, T. (2018). The Relation Between Epicardial Fat Tissue Thickness and TSH Receptor Antibody in Hyperthyroidism. Experimental and Clinical Endocrinology & Diabetes. https://doi.org/10.1055/a-0664-7746
3. Lanzolla, G., Sabini, E., Profilo, M. A., Mazzi, B., Sframeli, A., Rocchi, R., … Marinò, M. (2018). Relationship between serum cholesterol and Graves’ orbitopathy (GO): a confirmatory study. Journal of Endocrinological Investigation. https://doi.org/10.1007/s40618-018-0915-z
4. J AAPOS. 2018 Jul 31. pii: S1091-8531(17)30263-X. doi: 10.1016/j.jaapos.2018.04.009. [Epub ahead of print] The effect of oral statin therapy on strabismus in patients with thyroid eye disease.
Reynolds AL1, Del Monte MA2, Archer SM2.
5. Masetti, G., Moshkelgosha, S., Köhling, H.-L., Covelli, D., Banga, J. P., Berchner-Pfannschmidt, U., … Marchesi, J. R. (2018). Gut microbiota in experimental murine model of Graves’ orbitopathy established in different environments may modulate clinical presentation of disease. Microbiome,6(1), 97. https://doi.org/10.1186/s40168-018-0478-4
6. Conaglen, H. M., Tamatea, J. A. U., Conaglen, J. V., & Elston, M. S. (2018). Treatment choice, satisfaction and quality of life in patients with Graves’ disease. Clinical Endocrinology, 88(6), 977–984. https://doi.org/10.1111/cen.13611
7. Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., … Walter, M. A. (2016). 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid, 26(10), 1343–1421. https://doi.org/10.1089/thy.2016.0229
8. Comparative effectiveness of therapies for Graves’ hyperthyroidism: a systematic review and network meta-analysis. AU Sundaresh V, Brito JP, Wang Z, Prokop LJ, Stan MN, Murad MH, Bahn RS SO
J Clin Endocrinol Metab. 2013 Sep;98(9):3671-7. Epub 2013 Jul 3.
9. BENVENGA, S., AMATO, A., CALVANI, M., & TRIMARCHI, F. (2004). Effects of Carnitine on Thyroid Hormone Action. Annals of the New York Academy of Sciences, 1033(1), 158–167. https://doi.org/10.1196/annals.1320.015
10. Zeng, X., Yuan, Y., Wu, T., Yan, L., & Su, H. (2007). Chinese herbal medicines for hyperthyroidism. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD005450.pub2
11. AUF’MKOLK, M., INGBAR, J. C., KUBOTA, K., AMIR, S. M., & INGBAR, S. H. (1985). Extracts and Auto-Oxidized Constituents of Certain Plants Inhibit the Receptor-Binding and the Biological Activity of Graves’ Immunoglobulins*. Endocrinology, 116(5), 1687–1693. https://doi.org/10.1210/endo-116-5-1687
12. Pharmazie. 2005 Sep;60(9):696-700. Oxidative stress in Graves’ disease patients and antioxidant protection against lymphocytes DNA damage in vitro. Tang XL1, Liu XJ, Sun WM, Zhao J, Zheng RL.
13. Seo, G. H., Cho, Y. Y., Chung, J. H., & Kim, S. W. (2015). Increased Risk of Leukemia After Radioactive Iodine Therapy in Patients with Thyroid Cancer: A Nationwide, Population-Based Study in Korea. Thyroid,25(8), 927–934. https://doi.org/10.1089/thy.2014.0557
14. Thyroid nodules: diagnosis and management Rosemary Wong, Stephen G Farrell and Mathis Grossmann Med J Aust 2018; 209 (2): 92-98. || doi: 10.5694/mja17.01204 Published online: 16 July 2018

Written by Dr. Linda Khoshaba of Integrative Health. Dr. Linda Khoshaba has been practicing as an Associate Physician at Integrative health for 5 years. She specializes in treating Hashimoto’s and Graves thyroid disease, Adrenal Dysfunction and Hormone imbalance in both men and women.

Learn more about Dr. Khoshaba here.

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