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1/12/2022
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Living with Autoimmune Conditions: Graves' Disease

Written by
Brooke McKelvey
Team Nutrisense
Reviewed by
Cheri Bantilan
MS, RD, CD
a person examining their neck

Living with an autoimmune disease isn't easy, but according to the National Institutes of Health, a significant amount of Americans live with one—up to 23.5 million, in fact. The same report also found that they disproportionately affect women and that (for unknown reasons) their prevalence is rising. In the first of our series on autoimmune diseases, we told you more about Hashimoto's, which you can read about here. But just in case you need a little reminder, here's a refresher on what autoimmune diseases are before we dive into the next one in our series.

An autoimmune disease is when your immune system attacks organs, tissues, and cells. The causes for this are varied and could have to do with anything from genetics to bacteria, viruses, abnormalities, and certain drugs. It's not impossible, but not always easy to determine your risk factor for autoimmune diseases that are not genetic.

Type 1 diabetes, Hashimoto's disease, Rheumatoid arthritis, and Celiac disease are some you may recognize.

Autoimmune diseases affect everything from your pancreas, blood glucose levels, and thyroid glands to insulin secretion, blood pressure, and weight. So it's worth spending some time understanding the specifics of a few common autoimmune conditions. We're going to continue the series with another immune system disorder that affects thyroid function, called Graves’ disease.

What is Graves' Disease?

A woman being examined in a doctor's office

As we mentioned above, Graves' disease is an autoimmune disorder. The condition causes thyroid dysfunction and is one of the most common causes of hyperthyroidism. Interestingly, Graves' disease is named after the doctor who discovered it, Robert Graves.

So, what happens when you have Graves' disease? With this autoimmune condition, your thyroid begins to produce too much thyroid hormone. This increase in thyroid hormone levels affects several other things in your system.

Your immune system basically creates too many thyroid-stimulating immunoglobulins. In turn, these get attached to healthy thyroid cells. Eventually, this causes a thyroid disorder because of an overproduction of your thyroid hormones.

What are the Common Symptoms of Graves' Disease?

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Graves' disease, like most other autoimmune disorders, affects everyone differently. Some people may end up more at risk of kidney disease. For others, symptoms may include low blood sugar or an increased risk of type 2 diabetes. A long list of symptoms can help identify someone suffering from this autoimmune thyroid disease. Here's just a few:

  1. Weight Loss: Some thyroid disorders lead to weight gain—Graves’ disease does the opposite. Due to the overproduction of thyroid hormones, you may burn through calories and lose weight too quickly.
  2. Irregular Sleep: People who experience the onset of Graves' disease may find that their ability to sleep through the night gradually decreases.
  3. Increased Bowel Movements: Hyperthyroid diseases and autoimmune thyroid diseases like Graves’ disease often cause the bowels to overwork. This results in more bowel movements than usual, sometimes causing diarrhea.
  4. Goiter: Graves' disease can cause the thyroid to become inflamed and swell, also known as a goiter.
  5. Anxiety: Increased thyroid hormones may lead to anxiety in people who suffer from Graves’ disease.
  6. Weakness: Graves' disease may lead to muscle weakness and, as a result, some difficulty performing physical tasks.
  7. Hot Flashes and Heat Sensitivity: Hyperthyroid conditions like Graves' disease can increase sweating and heat sensitivity.
  8. Menstrual Changes: As endocrinology studies and reports show, women undergo more changes to their endocrine system than men in their lifetime. Not only is there a higher incidence of autoimmune conditions among women, but these conditions also affect their hormones. Women who suffer from Graves' disease may also find their menstrual cycle becoming irregular as a result.
  9. Erectile Dysfunction: Men may find that they develop erectile dysfunction as Graves' disease develops.
  10. Irregular Heartbeat: People who have Graves' disease may find themselves experiencing faster heart rates than regular or irregular heartbeats.

How to Detect Inflammatory Graves' Disease

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The first thing that your doctor will ask you if you have symptoms is whether or not you have a family history of Graves' disease. Because of the genetic link in autoimmune conditions, it's essential to maintain a family health history even if nothing is amiss. This can help your doctor pinpoint what you may be experiencing much quicker and with fewer tests if you end up suffering from any of the symptoms mentioned above.

If your doctor thinks you may have Graves' disease, they will likely run the following tests:

Blood Tests

Your doctor will run labs to search for the antibodies that trigger Graves' disease. If your thyroid is hyperactive, but they are not present, that means that your hyperthyroidism is likely caused by another condition.

Your doctor will run bloodwork to check your TSH (Thyroid-Stimulating Hormone). This is a test run to test for many different thyroid disorders. If you have Graves' disease, your TSH levels are suppressed while other hormone levels have risen.

Radioactive Iodine Test

Your doctor will give you a small amount of radioactive iodine and measure how much of it ends up in your thyroid gland. This is because your body requires iodine to create thyroid hormones. Using a special camera, your doctor can see how quickly your thyroid gathers the iodine. This is usually done after it is determined that you have hyperthyroidism. Once again, if this test doesn't show Graves' disease patterns, you will likely have a different hyperthyroid condition.

Imaging and Ultrasound Tests

Your doctor may run CT scans or an MRI to see if your thyroid is enlarged and inflamed.

They may also perform an ultrasound. Ultrasounds are often used by doctors to see if your thyroid gland is enlarged or inflamed. This test is often used to substitute the radioactive iodine test if you can't take that due to conditions like pregnancy.

Some Facts About Graves' Disease

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  1. Graves' disease affects approximately one out of every 200 people.
  2. Women are more likely to develop Graves' disease than men.
  3. Viral, bacterial infections have been known to trigger Graves' disease.
  4. A small portion of those affected by Graves' disease will develop pretibial myxedema or Graves' dermopathy, which causes a red rash on the skin on your lower legs and feet.
  5. Approximately 25-50 percent of people affected by Graves' disease develop Graves' ophthalmopathy. Graves' ophthalmopathy makes your eyes dry and red. This can occasionally progress into developing a bulging in your eyes.
  6. Graves' disease has been linked to developing osteoporosis, a disease that weakens your bones.
  7. Smoking cigarettes has been linked to an increased risk of developing Graves' disease. Smoking cigarettes can weaken your immune system.
  8. Pregnancy can become complicated if you develop Graves' disease. It can lead to possible miscarriage, preterm birth, maternal heart issues, slow fetal growth, and other complications. If you think you have any of the symptoms of Graves' disease when you're pregnant, it's best to visit a doctor without delay.

How to Treat Graves' Disease

A person holding yellow pills

As with many autoimmune disorders, there is no cure for Graves' disease, but there are several different treatment options to manage and negate your symptoms. It will be up to you and your doctor to formulate a suitable treatment plan for Graves' disease after you are diagnosed. The goal of any treatment is to slow the production of thyroid hormones.

The most commonly used treatment is medication. There are many different brands of antithyroid medicines. One of these may be your doctor's first suggestion to slow the production of thyroid hormones. Some doctors may also use beta-blockers that have the same effect. Beta-blockers may also help reduce the symptoms of your hyperthyroidism.

Radioactive iodine therapy is the second most common treatment for Graves' disease. This is administered orally in the form of a pill. During the treatment, iodine is transferred to the thyroid gland. The radiation in it kills some of the cells, slowing down the production of thyroid hormones (like thyroxine and triiodothyronine).

This type of treatment has some risks due to the radiation, so if you're pregnant or have other health conditions, it's likely not a good option. Make sure to tell your doctor about any potential problems and discuss this in detail before agreeing to the treatment.

The last treatment commonly used to treat Graves' disease is thyroid surgery. This is the least common way to treat Graves' disease. Still, it may be necessary to develop a goiter or are in a more advanced stage of the disease when diagnosed. The procedure will remove part or all of your thyroid. You will likely need to take thyroid medication daily for the remainder of your life if you have this type of surgery.

Your Blood Sugar and Graves' Disease

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Monitoring blood sugar levels is an essential part of diabetes care, but diabetes patients aren't the only people who should focus on blood glucose. Monitoring and managing blood glucose to ensure they're within a normal range can be an effective way to see if you're at risk of things like type 2 diabetes and insulin resistance. It's also an excellent way to prevent prediabetes and optimize overall health and wellness.

And whether you're a diabetic patient or not, thyroid diseases can make controlling your blood sugar levels more difficult. This is because hyperthyroid conditions like Graves’ disease can sometimes trick your body into craving sugar due to varying symptoms. Additionally, hyperthyroidism can, in some cases, cause your medications to be absorbed quicker than usual. If you are on any kind of diabetes medication, monitor this as it may result in blood sugar spikes. Thyroid disorders like Graves' can also cause hyperglycemia.

Because they're both endocrine disorders, there's a link between thyroid disorders and diabetes, as the American Diabetes Association explains. People with type 1 or type 2 diabetes or insulin resistance can often be at a higher risk of developing thyroid diseases like Graves' disease. And people with autoimmune disorders like Graves’ disease can sometimes be more at risk of developing type 2 diabetes.

So, it's a good idea to wear a glucose monitor or check your blood sugar levels frequently to see how your blood glucose and hyperthyroidism interact. Using a continuous glucose monitor (CGM)is a non-invasive, easy way to track this data. Healthcare professionals like doctors or registered dietitians can help you read the data and understand more about hypoglycemia, hyperglycemia, insulin resistance, and impaired glucose tolerance, which can affect autoimmune conditions like thyroid dysfunction. They can also help you with better blood sugar management.

Diet Guidelines to Help with Graves' Disease

A plate of grilled fish and salad

Do you usually focus on your food's glycemic index, carbohydrate, and fat content because you want to lose weight? Concentrating on what you eat helps with more than weight gain issues. Here are a few diet guidelines to help you manage and monitor Graves' disease.

  1. Because of the effect that Graves' disease can have on your bones, it's a good idea to ensure that you're getting enough calcium in your diet.
  2. A vitamin D deficiency can exacerbate or increase your risk of Graves' disease, so increase your exposure to it and increase your intake of vitamin D foods. Vitamin D can help bolster your system and regulate insulin and blood sugar levels.
  3. Eat lots of protein-rich food to stave off the weight loss that Graves' disease can cause.
  4. Avoid gluten, especially if you have Celiac disease, as it has been linked to Graves' disease.
  5. Consider consuming foods that contain natural supplements like magnesium to help your body absorb calcium.

Many nutrient-rich foods can help you control your hyperthyroid symptoms. Talk to your doctor or work with a dietitian to understand how dietary changes can help you manage conditions like Graves' disease.

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