In Part 1 of this series on Graves’ disease I covered the basics in terms of definitions, symptoms and diagnosis of Graves’ disease. Today, I’m going to dive into the functional medicine approach to Graves’ and how it differs from the conventional approach. Functional medicine often offers more treatment options and an increased quality of life. 

Keep reading to learn more about:

• Is Graves’ disease curable?
• The functional vs. conventional medicine approach to Graves’ 
• Functional medicine nutrition and lifestyle support for Graves’

Let’s get started!

Can Graves’ Disease Be Cured?

Is Graves’ disease curable? Is the question on everyone’s mind! When using functional medicine approaches, I’ve certainly seen cases where autoimmune disease is reversed or put into remission. It may depend upon the person and how far advanced the disease is in terms of damage to tissues, but there is a lot that functional medicine offers. 

To be clear, this isn’t a quick fix or singular strategy, but instead a comprehensive approach that addresses each person’s unique root causes. It often requires building new lifestyle habits, diet change, stress reduction and other pieces that take dedication and consistency. 

I’ve talked quite a bit in previous articles about the root causes to autoimmunity, and the same principles apply to Graves’. In all autoimmune disease, three things are present: 

1. a genetic predisposition, 
2. intestinal permeability and
3. a trigger. 

Looking at gut health, toxin exposure (such as mercury), gluten sensitivity and hidden infections is a great place to start!

Please read A Functional Medicine Approach To Autoimmune Disease to learn more. I’ll discuss possible Graves’-specific solutions below. 

Functional Vs. Conventional Approach

In conventional, Western medicine the most common Graves’ disease treatment approach is medication that blocks thyroid hormone. This medication is not without side effects. One study in pediatric Graves’ patients using Methimazole found that 20-50 percent experienced an adverse event from the medication. 

For 50 percent of those with Graves’ disease, medications don’t work, and more invasive strategies ensue. The first option is thyroid ablation, where radioactive iodine is used to destroy thyroid cells. This treatment requires long-term follow up and dependence upon thyroid replacement hormone for life. In addition, the risk for breast and thyroid cancer increases. 

The other option is a partial thyroidectomy, where part of the thyroid gland is surgically removed. Thyroid hormone replacement is often necessary in this case as well. 

While these strategies are needed in some cases, they are often the only treatments discussed following a Graves’ diagnosis, which can be overwhelming and scary. These strategies will lower the amount of circulating thyroid hormone, but they don’t address the underlying dysfunction in the immune system, which may lead to other issues down the road. Uncovering and addressing root causes is where functional medicine shines! 

For those that choose, or require, medication, ablation or surgical removal of thyroid tissue, functional medicine is an important adjunct to promote healing and optimal health moving forward. 

Diet, Nutrition And Graves’ Disease Improvement

Nutrition is the cornerstone of functional medicine and a foundational approach to managing thyroid symptoms and improving thyroid gland function. A gluten-free nutrient dense diet supports immunity and provides the nutrients required for optimal thyroid function. The best Graves’ disease diet is a plant-rich, whole food diet that has been personized to your individual nutrition needs and food sensitivities. 

In addition to diet, quality sleep, stress management, movement and hormone balance are all foundational areas to work on optimizing. 

Here are my top Graves’ disease treatment tips:

• Work with a functional medicine doctor. There are things you can do your own, but having the guidance of a practitioner knowledgeable about autoimmune disease from a functional medicine perspective changes the game. Benefits include access to comprehensive thyroid hormone function and antibody testing, advanced functional medicine testing, conventional medication and treatment, personalized protocols, supplements and more. In addition, when you find a practitioner that you are comfortable with and collaborate with as equals, the therapeutic relationship becomes a healing one. 

• Optimize vitamin D levels. Vitamin D is incredibly important for balanced immune function. Those with autoimmune disease, including Graves’, often present with deficient or suboptimal levels of vitamin D in the blood. Restoring levels, through proper testing and supplementation, helps to modulate the immune system and may decrease the risk of thyroid cancer. 

• Support microbiome health. You may be familiar with the gut-brain access, or the bidirectional communication between the gut and brain. Similarly, scientists now describe a gut-thyroid access, where the health of the microbiome influences thyroid function. Keep your thyroid healthy be eating microbiome supportive foods including fermented foods and colorful, fiber-rich plant foods. 

• Kill unwanted microbes. Bacterial infections, including H. Pylori, and viruses, including Epstein Barr virus, have been linked to autoimmune thyroid disease. Testing and effective treatment will require working closely with your functional medicine provider. 

• Supplement smart. Certain nutrients and herbs may help to naturally suppress thyroid function in Graves’ disease. L-carnitine, lemon balm, selenium and iodine may be options to discuss with your functional medicine provider. 

A Graves’ diagnosis is understandably challenging and scary to navigate, but a functional medicine approach brings comfort, clarity and many medical and holistic tools to the table. With the right approaches and support, you may find symptom management while preserving thyroid function. Interested in learning more? Give my clinic a call today! 

References

1. Yasuda, K., Miyoshi, Y., Tachibana, M., Namba, N., Miki, K., Nakata, Y., Takano, T., & Ozono, K. (2017). Relationship between dose of antithyroid drugs and adverse events in pediatric patients with Graves' disease. Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology, 26(1), 1–7. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295245/ 
2. Chen, Y. K., Lin, C. L., Chang, Y. J., Cheng, F. T., Peng, C. L., Sung, F. C., Cheng, Y. H., & Kao, C. H. (2013). Cancer risk in patients with Graves' disease: a nationwide cohort study. Thyroid : official journal of the American Thyroid Association, 23(7), 879–884. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3704114/ 
3. Kim D. (2017). The Role of Vitamin D in Thyroid Diseases. International journal of molecular sciences, 18(9), 1949. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618598/ 
4. Knezevic, J., Starchl, C., Tmava Berisha, A., & Amrein, K. (2020). Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function?. Nutrients, 12(6), 1769. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353203/ 
5. Shi, W. J., Liu, W., Zhou, X. Y., Ye, F., & Zhang, G. X. (2013). Associations of Helicobacter pylori infection and cytotoxin-associated gene A status with autoimmune thyroid diseases: a meta-analysis. Thyroid : official journal of the American Thyroid Association, 23(10), 1294–1300. Abstract: https://pubmed.ncbi.nlm.nih.gov/23544831/ 
6. Benvenga, S., Ruggeri, R. M., Russo, A., Lapa, D., Campenni, A., & Trimarchi, F. (2001). Usefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind, placebo-controlled clinical trial. The Journal of clinical endocrinology and metabolism, 86(8), 3579–3594. Abstract: https://pubmed.ncbi.nlm.nih.gov/11502782/ 
7. 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. Abstract: https://pubmed.ncbi.nlm.nih.gov/2985357/ 
8. Duntas L. H. (2012). The evolving role of selenium in the treatment of graves' disease and ophthalmopathy. Journal of thyroid research, 2012, 736161. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270443/