Graves’ Disease Symptoms And Causes

Thyroid disease is a common contributor to hormone imbalance in women and one that I see almost daily in my practice. Hypo thyroidism, and specifically, Hashimoto’s thyroiditis, gets the most attention, simply because it is most prevalent. But today I want to shine a light on the other end of the spectrum: hyper thyroidism, and specifically, Graves’ disease.

Keep reading to learn more about:

Hyper thyroidism vs. hypo thyroidism Hyperthyroidism vs. Graves’ disease Hyperthyroid and Graves’ symptoms The immune system connection Graves’ disease diagnosis and other causes of hyperthyroidism

Let’s get started!

What Is Graves’ Disease?

Let’s start with the basics. Your thyroid is an endocrine gland that sits in the front of your neck and produces thyroid hormone. Thyroid hormone is required to set the metabolic rate of each cell in the body.

When the thyroid gland is working properly, we don’t give it much thought. However, when the thyroid produces too little thyroid hormone, called hypo thyroidism, everything slows down creating fatigue, constipation, depression and hair loss. When the thyroid produces too much thyroid hormone, called hyper thyroidism, a whole set of other symptoms are experienced.

What is Graves’ Disease? Graves’ disease is in the category of immune system disorders called autoimmune disease . While Hashimoto’s thyroiditis (add link to Hashimoto’s article) is the autoimmune version of hypo thyroidism, Graves’ disease is the autoimmune hyper thyroid disease.

Graves’ disease is the most common form of hyperthyroidism where thyroid hormone production is overactive producing a high metabolic rate, an increased need for nutrition and a host of hyperthyroidism symptoms.

Graves’ disease symptoms and signs include:

Increased hunger Weight loss (unintentional) Hot flashes Sweating Frequent or loose stools Insomnia Anxiety Rapid heart rate/heart palpitations Hyperactivity Muscle weakness Warm and moist skin Agitation Fatigue Heat intolerance Tremor Changes in the menstrual cycle Graves’ ophthalmopathy – bulging eyes Graves’ dermopathy – thick red skin on shins or top of feet Goiter Osteopenia/osteoporosis

If not managed, Graves’ disease may cause damage to the body, including heart complications. Thyroid storm, or thyrotoxic crisis, is a rare and life-threatening complication of Graves’ disease where levels of thyroid hormone become extremely elevated.

Those with Graves’ are also at higher risk of developing other autoimmune disease because of the similar root causes. And interestingly 10 to 20 percent of people with Graves’ disease go on to develop hypothyroidism or Hashimoto’s .

Graves’ And Thyroid Disease

What causes Graves’ disease? It’s helpful to think of Graves’ as an immune disease affecting the thyroid instead of an independent thyroid disease. I’ll dive more into this in Part 2 of this series where I discuss a functional medicine approach to Graves’ disease treatment.

With this perspective, we begin to uncover the specific aspects that lead to development of autoimmunity for each individual, including a genetic predisposition, intestinal permeability (leak gut) and environmental triggers.

Read more about this in Graves’ Disease Part 2 here .

Graves’ Disease Diagnosis

When Graves’ symptoms are present, blood testing is helpful for diagnosing Graves’ and distinguishing it from other forms of hyperthyroidism. As with Hashimoto’s, antibody testing is important.

Antibody thyrotropin receptor antibodies (TRAb) is most often elevated in Graves’, although not always. This antibody mimics the pituitary hormone called thyroid stimulating hormone (TSH) that signals the thyroid to produce more thyroid hormone.

It’s also possible to have elevated thyroid peroxidase antibodies (TPO) and thyroglobulin antibodies in Graves’ even though these are most commonly associated with Hashimoto’s.

In my practice, I run a full thyroid panel along with these three antibodies.

While Graves’ disease is the most common reason for hyperthyroidism, other reasons for hyperthyroidism include:

Toxic multinodular goiter (enlarged thyroid with nodules) Toxic adenoma (benign tumor that produces thyroid hormone) Thyroiditis (an acute event of hyperthyroidism, often followed by hypothyroidism, such as postpartum thyroiditis)

Other testing that is sometimes used to get the proper diagnosis includes radioactive iodine uptake. High iodine uptake is associated with Graves’. Thyroid ultrasounds are used to look for thyroid nodules, or lumps in the thyroid gland.

Now that we’ve covered the basics of Graves’ disease, including symptoms and testing, stay tuned for Part 2 of this article where I cover a functional medicine approach to Graves’ disease and how to restore thyroid function by addressing the root causes.

References

Subekti, I., & Pramono, L. A. (2018). Current Diagnosis and Management of Graves' Disease. Acta medica Indonesiana , 50 (2), 177–182. Full text: http://www.actamedindones.org/index.php/ijim/article/view/817/pdf Umar, H., Muallima, N., Adam, J. M., & Sanusi, H. (2010). Hashimoto's thyroiditis following Graves' disease. Acta medica Indonesiana , 42 (1), 31–35. Full text: http://www.inaactamedica.org/archives/2010/20305330.pdf