Graves’ disease is an autoimmune disease in which the body attacks itself. The body’s immune system is designed to produce antibodies to protect the body from foreign invaders including germs, bacteria, and viruses. In an autoimmune condition, the immune system produces antibodies against itself. These antibodies mistake healthy tissue, cells, muscles, organs, and joints for foreign substances and attack.
In the case of Graves’ disease, the immune system damages the thyroid gland, which in turn begins to overproduce the thyroid hormone. While the thyroid hormone is essential for keeping the body healthy and properly functioning, an overabundance of the hormone throws the body’s many systems into overdrive, creating serious health risks.
Graves’ disease is named after Dr. Robert Graves, an Irish physician who was one of the first physicians to understand and explain the condition that was previously known as exophthalmic goiter or toxic diffuse goiter. Graves’ disease is now considered a highly treatable condition when it was once thought to be a fatal diagnosis.
According to the American Thyroid Association, approximately 20 million Americans have some type of thyroid condition. Graves’ disease is a less common thyroid disease, affecting approximately 1% of the population. Graves’ disease is genetic and can occur at any age but is typically seen in middle age.
What Is the Thyroid and What Does It Do?
In order to understand Graves’ disease and its effects on the body, one must first understand the thyroid and its role in the body. The thyroid is a butterfly-shaped gland positioned low in the neck, just below the Adam’s apple. The thyroid’s job is to produce thyroid hormone, which plays an integral part of a normal, healthy body. The thyroid hormone affects just about every part of the body, particularly the body’s metabolism and heart rate.
Graves’ disease causes overactive thyroid, or hyperthyroidism, which means the thyroid begins to overproduce the thyroid hormone. This wreaks havoc on the body, causing those with Graves’ to rapidly lose weight, become shaky and irritable, and to experience heart palpitations, among other symptoms.
Graves’ disease symptoms will vary from patient to patient depending on various factors such as how long the patient has had the disease and how the disease affects each patient individually. However, there are some common symptoms that are seen in most cases of Graves’ disease.
Diagnosing Graves’ Disease
Diagnosing Graves’ disease can be difficult if there is no known family history of an autoimmune disease. Without a known history and in the absence of a goiter, or visibly enlarged thyroid, doctors may need to rule out other conditions before discovering the problem with the thyroid.
Even with a family history of autoimmune conditions, many autoimmune diseases present with similar symptoms. Since the thyroid affects every system in the body, it may be difficult to pinpoint exactly what is causing such a mix of symptoms. Patients presenting with multiple symptoms such as gastrointestinal problems, palpitations, sexual problems, and anxiety may see a variety of specialists before being referred to an endocrinologist, who specializes in thyroid disorders.
Once a physician suspects the thyroid may be the culprit, he or she will likely order a series of tests to confirm or rule out thyroid disorders such as Graves’ disease. According to the American Thyroid Association, common blood tests include:
- Thyroid Hormone Tests that measure the amount of the thyroid hormones thyroxine (T4) and triiodothyronine (T3) in the blood
- Thyroid-Stimulating Hormone (TSH)
- Thyrotropin Receptor Antibodies (TRAbs)
Typically, with hyperthyroid conditions, the amount of T4 and T3 is high and the amount of TSH is low. These blood tests will help the physician make a diagnosis of hyperthyroidism. If hyperthyroidism is detected, the physician will next check for antibodies that indicate Graves’ disease is the cause of the hyperthyroid condition.
Treatment for Graves’ Disease
Graves’ disease treatment will vary depending upon the individual and the severity of the disease. Additional factors such as age and other underlying medical conditions may affect treatment options. The following are the most common forms of treating Graves’ disease.
Anti-thyroid drugs work by blocking the thyroid from producing new hormones. The American Thyroid Association reports that treatment using anti-thyroid drugs results in remission of Graves’ disease in approximately 20–30% of cases.
Radioactive Iodine Treatment
Thyroid cells produce thyroid hormones by taking up any form of iodine in the bloodstream. Some physicians will treat Graves’ disease by having the patient swallow a small pill filled with radioactive iodine. The thyroid cells will take up the radioactive iodine once it’s in the bloodstream, and then the iodine will destroy the thyroid cells. It is possible for a patient to undergo multiple rounds of radioactive iodine treatment, though they might need to wait several weeks or months in between treatments to allow the body to flush out any radioactive iodine that was not taken up by the thyroid cells.
If anti-thyroid drugs or radioactive iodine do not put Graves’ disease into remission, a third option is surgery to remove part or all of the thyroid gland. A total thyroidectomy will establish a state of permanent remission, as it will not be possible for the thyroid to become overactive again. However, people need thyroid hormones to stay healthy. Once the thyroid is removed, the patient will have a condition known as hypothyroidism, in which the thyroid is producing too little thyroid hormone or, in the case of thyroid removal, none at all.
After surgery, the patient will begin taking a daily thyroid hormone supplement. The supplement dosage will be monitored through blood work for the rest of the patient’s life to ensure it is at an adequate amount to keep the patient healthy. Hypothyroidism can also occur after use of anti-thyroid drugs and radioactive iodine treatment. If this happens, the same treatment will be prescribed, a daily thyroid hormone supplement.
Amino Acid Supplements
Some Graves’ disease patients may find that taking amino acid supplements helps improve their hyperthyroid symptoms. Amino acids help the body form protein, which is essential for maintaining a healthy, functioning body. As the building blocks of protein, amino acids build muscles and tissues and help the body make chemicals that are essential for healthy functioning organs, including the brain.
The amino acid L-carnitine may help treat some symptoms of an overactive thyroid condition, such as Graves’ disease. Symptoms that may be improved include rapid heartbeat, nervousness and shakiness, and weakness. Researchers from the University of Maryland Medical System have suggested that L-carnitine may work by blocking the thyroid hormone. Since Graves’ disease occurs when the body produces too much thyroid hormone, L-carnitine may have beneficial effects for those with Graves’ disease. However, those with hypothyroidism, or underactive thyroid, should avoid L-carnitine since they are already not producing enough thyroid hormone and should not block any additional thyroid hormone from being made.
Even though L-carnitine may have beneficial effects for Graves’ patients, it’s best to take a balanced mixture of all essential amino acids to make sure that the blood concentration of amino acids is optimal, and always discuss any supplements with a physician before starting them.