What is Graves Disease?

Graves Disease in Five Sentences

1. Graves disease is a type of autoimmune disease.
2. An autoimmune disease is where your immune system is mistakenly attacking a part of its own body, instead of just foreign invaders such as bacteria and viruses.
3. In the case of Graves disease, the immune system is attacking the thyroid.
4. The thyroid responds to this attack by producing too many hormones, known as an overactive thyroid or hyperthyroidism.
5. The problem with having too many of these thyroid hormones is your body relies on having the right level to function correctly and well. Everything that makes you feel like you, is dependent on having a healthy thyroid. Thyroid hormones are critical to life.

Autoimmune Diseases

To understand Graves disease you must first understand autoimmune diseases. An autoimmune disease occurs when your immune system attacks a healthy part of your body.

Believe it or not, you cheat death on a daily basis, sometimes several times a day. You could become infected with a deadly virus, develop a bacterial or fungal infection that eats you alive, or develop cancer when a simple cell mutates and turns into something it shouldn’t be. But you don’t, because those viruses are burned alive, the bacteria are shot to pieces and that rogue cell is surrounded and destroyed before it can go on to mutate and replicate. Sometimes you know you’re “fighting something”, but most times you don’t.

Who do you have to thank for this? Your immune system. It is the 'army' that provides this essential, lifesaving function of attacking and destroying anything foreign in your body.

So What Goes Wrong?

This army is pretty well trained, and it is not in the business of 'friendly fire'. After all you do not want it going around randomly and indiscriminately killing cells that are the good guys. But in some people the immune system gets it wrong and loses the ability to distinguish “foreign” from “self” and attacks healthy parts of its own body. This is known as an autoimmune disease. Antibodies, the very front line of the immune system are incorrectly targeted against otherwise healthy cells, tissues and organs.

There are almost 100 types of immune diseases, differing only by what part of the body is being attacked. And depending on the body part, they vary in severity. Examples include Multiple Sclerosis, where the immune system is attacking the nervous system, and Type 1 Diabetes, where the immune system is attacking insulin producing cells in the pancreas. And then there is Graves Disease, where the immune system is attacking the thyroid gland.

The Thyroid Gland

The thyroid is a butterfly shaped gland that is part of the endocrine system. You can find it just below your Adams apple on the front of your neck.

The endocrine system is a sophisticated network of glands that produces and secretes hormones that regulate our cells and organs. These hormones are critical for the operation of our bodies. The major glands of the endocrine system are the hypothalamus, pituitary, thyroid, parathyroid, adrenals, pineal body, and the reproductive glands (ovaries & testes).

The primary role of the thyroid in adults is to produce and secret hormones into your blood stream that regulate the body's metabolism. Metabolism is a term that is used to describe all chemical reactions involved in maintaining the living state of the cells and the body.

The two main hormones the thyroid produces are Triiodothyronine (T3) and Thyroxine (T4). If you have too much or too little of these hormones, your metabolism either speeds up or slows down, in either case throwing you and your body off balance and impacting everything from blood pressure and heart rate, to digestion and brain function.

The quantity of hormones produced by the thyroid is regulated by the pituitary gland, which in turn is regulated by the hypothalamus.

If your body needs more thyroid hormones the signal is sent from the hypothalamus to the pituitary gland in the form of a "releasing hormone" (TRH). This stimulates the pituitary gland to secrete a "stimulating hormone" (TSH) into the bloodstream which signals to the thyroid to secrete its hormones. If your body has enough thyroid hormones then the process is put on hold until such time they are required. It works very much like the thermostat in your house: checking levels in your blood regularly and switching on or off as needed to maintain the perfect balance and a stable level of hormones.

What Happens When The Thyroid Is Attacked?

When your immune system produces antibodies (called TRAbs) they attack the thyroid, confusing it and making it produce ever increasing quantities of thyroid hormones. This is known as an overactive thyroid, or hyperthyroidism. When this happens, you will have far too much T3 and T4 travelling around your blood stream, speeding up your metabolism, impacting the healthy, optimal function of your body and causing the debilitating symptoms you are now experiencing.

Normally this production would stop as the pituitary gland would see the high levels in your blood and turn off production of TSH and that would stop this rollercoaster. But for you and I, there is no off valve and the pituitary gland is powerless to stop the antibodies from stimulating the thyroid. This is why Graves is typically diagnosed by the following labs:

• The presence of TRAbs (Thyroid Stimulating Hormone Receptor Antibodies)
• High T3 and T4
• Low TSH

Signs & Symptoms of Graves Disease

There are many signs and symptoms of Graves, and it is important to remember:

1. Not everyone experiences all of these symptoms and they may come and go as your disease worsens, or improves.
2. Most issues are caused by the body reacting to the high levels of thyroid hormones (T3 and T4) in the blood. Higher levels generally mean more symptoms and of greater severity.
3. One of the reasons Graves takes so long to diagnose, is that these symptoms are non-specific and at times can be explained away easily by what might seem like the everyday stresses of busy life.

Common symptoms include:

• nervousness, anxiety, irritability and high emotions
• tremors and muscle weakness
• heat intolerance and excessive sweating
• fatigue and interrupted sleeping patterns
• unexplained weight loss or weight gain
• increased heart rate and palpitations
• rapid pulse
• infrequent menstrual cycles and bleeding patterns
• infertility
• diarrhoea and fatty stools
• shortness of breath, especially when exercising
• thinning hair
• enlarged thyroid gland (goiter)
• double vision, photosensitivity and protruding eyes
• extremely dry skin, especially on the shins
• painful feet, especially upon waking

What Causes Graves Disease

No one can definitively say what causes Graves, or any autoimmune disease. However, there is an emerging body of evidence that shows that they are caused by a combination of genetic predisposition (you must carry the genes) and environmental factors (something causes your body to turn these genes “on”).

Genetics likely has a strong influence. There is a substantial body of evidence that susceptibility to an autoimmune disease is inherited. This doesn’t mean you will definitely get the disease, only that you are more likely. Some autoimmune diseases run in families, and women are much more likely to be sufferers.

Diet is one of the biggest environmental factors believed to trigger Graves. In particular it is believed that the western diet of highly processed food, increased dairy and gluten consumption, sugars and other foods linked to inflammation and poor gut health, cause a leaky gut (technically called “Increased intestinal permeability”) which sets off the immune system.

Environmental factors such as stress, deficiencies in particular nutrients, smoking, exposure to toxins, drugs and everyday solvents have all featured in studies and research as causes of Graves disease. It is believed that inflammation caused by these factors somehow triggers an abnormal immune system response.