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Graves Disease Treatment


Introduction

Before covering the treatment of Graves disease, it is important to understand that Graves disease is not caused by the thyroid. The thyroid is actually the victim. Graves disease is caused by an out-of-control immune system which is producing antibodies to mistakenly attack and overstimulate the thyroid, causing it to produce ever increasing quantities of thyroid hormones. Whilst these hormones are required by the body to function normally, too many can cause a wide range of distressing and painful symptoms and problems.

There are three main conventional treatment pathways for Graves disease:

1. Anti-thyroid drugs (ATDs)

2. Surgical removal of the thyroid (Thyroidectomy)

3. The destruction of the thyroid via radioactive iodine (RAI).

Anti-Thyroid Drugs

Anti-thyroid drugs (or ATDs) are typically the first step in the treatment of Graves disease. These drugs work to stop the thyroid from secreting thyroid hormones, with the goal of reducing the levels in the bloodstream to within a normal range.

They are usually taken in tablet form and the dosage varied depending on your current level of thyroid hormones (TSH, T3 and T4).

Beta-blockers can also be used alongside ATDs, especially for those with extreme symptoms or exceptionally high T3 and T4 levels. Beta-blockers do not reduce the levels of thyroid hormones, instead they act to stop their effects and reduce symptoms very quickly.

There are two methods of using ATDs:

  • Titration Method - The dose of the ATD is continually lowered as your T3 and T4 levels come down, with the aim being to get you to the lowest possible dose of drugs needed to maintain normal thyroid hormone levels.

  • Block & Replace Method - ATDs are taken in a higher dose to completely stop the thyroid from producing T3 and T4 (this is the 'block' part of the protocol), whilst simultaneously a synthetic T4 tablet is taken to "replace" the hormones the thyroid should normally produce.

ATDs are generally very effective at reducing T3 and T4 levels and controlling the symptoms of Graves disease. One common issue is getting the dosage correct. Particularly with the titration method, there is a risk of a yoyo effect where the dosage is too high and T3 and T4 are reduced too far.

Often the biggest challenge with ATDs is the risk that long term usage can have on your liver health. It is for this reason that many Graves patients find themselves, after a period of time on ATDs, facing a recommendation from their endocrinologist to either remove their thyroid via surgery, or destroy it via radioactive iodine.

Surgical Removal of the Thyroid (Thyroidectomy)

This treatment option is based on removing the thyroid surgically and replacing its function with a synthetic T4 hormone.

All or part of the thyroid is removed surgically, usually under general anaesthetic. Before surgery, ATDs are given for a short period of time (usually 6 weeks), as well as an iodine solution to make the thyroid easier to remove.

A small incision is made on the front of the neck, directly below the thyroid and the thyroid is then carefully removed. The incision is stitched up and hospital discharge usually occurs in 1-2 days.

Whilst surgery is often considered a long term or "definitive solution" to Graves disease, it is by no means a perfect solution for two main reasons:

  • No thyroid means no production of T3 or T4. So the body goes from having too many thyroid hormones, to having too few. This is known as hypothyroidism, and usually comes with other equally distressing symptoms such as uncontrollable weight gain, exhaustion, temperature intolerance, hair loss and many others. After a thyroidectomy, you will need to take a synthetic T4 hormone for the rest of your life.

  • It is likely that your immune system is still misbehaving and producing antibodies, and can therefore go on to cause problems elsewhere, including Graves eye disease and other autoimmune diseases.

Radioactive Iodine Treatment (RAI)

Similar to surgery, this treatment option is based on destroying the thyroid, and replacing its function with a synthetic T4 hormone.

A small pill containing a radioactive isotope is administered in hospital. The body is tricked into thinking this is iodine, causing the thyroid to absorb it (iodine is to the thyroid what a magnet is to metal). The radioactive isotope destroys the tissue of the thyroid, causing it to degenerate and die.

RAI is usually administered as an outpatient treatment but requires strict controls to avoid coming into contact with babies, small children, pregnant women, and pets, for up to 3 weeks.

The implications of this treatment option are very similar to that of surgery: patients need to take a synthetic T4 hormone for the rest of their life, and it doesn’t address the underlying immune system issue.  

Treating the Cause – An Out of Control Immune System

Removing the thyroid, whether by surgery or RAI, never made much sense to me. It's akin to having the engine light come on in your car, and instead of fixing the problem that caused the engine light to come on, you take out the bulb and pretend that the problem has gone away!

So what about treating the underlying cause of Graves disease? The good news is that there is an ever increasing body of peer-reviewed scientific research and patient success stories, which show that by improving critical factors such as gut wall integrity, diet and nutritional deficiencies, lifestyle, and environmental factors, the immune system can be calmed, the production of the antibodies which are attacking the thyroid can be stopped, and remission can be achieved.

Fighting Graves is a 12 week program that is based on this body of research and evidence, and documented results amongst Graves and many other autoimmune patients.

It is an easy-to-follow, downloadable eBook that was written by me, a Graves' patient and contains everything I learned and did to successfully reverse my Graves’ disease and achieve complete remission. It has now been used by many, many others to reverse their Graves' disease too.