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The Investigation

Thyroid issues can be so frustrating because often doctors will say there is nothing to be done other than taking medication.

We talk a lot about hypothyroidism and Hashimoto’s Disease (an autoimmune disease that attacks the thyroid resulting in not enough thyroid hormone) but there is another side to thyroid issues. 

It is also possible for there to be too much thyroid hormone being produced. This is called hyperthyroidism and the autoimmune disease that can cause this is Graves' Disease. 

But it is also possible for those with Hashimoto’s disease to experience periods of hyperthyroidism - which just adds to the thyroid mystery. 

In this episode of Health Mysteries Solved, we’re exploring hyperthyroid symptoms in Graves' as well as in Hashimoto’s. To help with this discussion, I invited fellow clinical nutritionist, Juli Keene, on the show. She’s based in Los Angeles and has been in practice for over 25 years often helping professional athletes and high-functioning folks with complicated health issues. She’s also a real expert on Graves' Disease. 

What is Graves' Disease?

Graves' Disease is an autoimmune disease affecting the thyroid. What’s happening with Graves' is that there is an immune attack and antibodies get created. These antibodies attack the thyroid and stimulate the hormone receptors. This results in an overproduction of thyroid hormones and a hyperactive thyroid.

It can be very dangerous to have too much thyroid hormone and needs to be addressed right away.

The Difference Between Graves' Disease and Hashimoto’s Disease

With Hashimoto’s, the immune system is attacking the thyroid resulting in reduced hormone production (hypothyroidism) and with Graves' it’s the opposite. However, the nuances between the two autoimmune diseases are more complex, especially if you have Hashimoto’s. With Graves', the levels continuously escalate. However, with Hashimoto’s, there can be flare ups that present like Graves' where the thyroid swings from not producing enough to overproducing. So, someone with Hashimoto’s might have a flare up and suddenly have hyperthyroid symptoms.

It’s also worth noting that someone with Hashimoto’s can also have Graves' disease too (although it’s not common). It’s all in how and when the immune system produces the different antibodies and how these antibodies succeed in destroying the thyroid.

Symptoms of Graves' Disease

Unlike the symptom of Hashimoto’s where people feel sluggish (when not in a flareup that is), people with Graves' might report feeling great. They have lots of energy, their weight is good, and they are often in a good mood. But soon, this can slide into feelings of anxiety, sometimes a sense of feeling manic, and even experiencing heart palpitations. Soon, they may also swing into weight loss, and brain fog.

With Graves', the symptoms can go up and down but generally progress.

The most common symptoms include:

• Irregular & rapid heartbeat
• Heart palpitations
• Hand and finger tremors
• Anxiety and irritability
• Unexplained weight loss paired with insatiable hunger
• Heat sensitivity (sweating and hot flashes)
• Muscle weakness
• Hair loss.
• Visibly enlarged thyroid gland (sometimes it can develop into a goiter)
• Menstrual cycle irregularities
• Low or no sex drive
• Diarrhea or IBS
• Insomnia
• Decreased bone density and low calcium levels

Diagnosing Graves' Disease

Graves' disease can be diagnosed with a blood test. Generally, this includes a full thyroid panel and TSI Antibodies. 

If you are talking with a conventional doctor because you have symptoms that might indicate Graves' it’s important to ask for the full thyroid panel and look specifically at the TSI antibodies.

Conventional Treatment for Graves' Disease

Graves' is a dangerous condition. Doctors usually put the patient on thyroid suppressing hormone medication. They may also add a beta blocker to slow down heart palpitations.

Many conventional doctors will also recommend a treatment that destroys the thyroid and requires the patient to be on thyroid replacement medication after the procedure to have a better handle on thyroid hormone levels. 

Contributing Factors to Graves' Disease From An Integrative Perspective

As mentioned, Graves' disease or symptoms and labs that suggest Graves' need to be taken seriously. Ideally, you would see an endocrinologist as well as an integrative doctor or nutritionist who understands Graves' and can look at some of the underlying issues that conventional doctors may miss that could be contributing to the severity of your condition.

Potential contributing factors could include:

• Infections or viruses (like H. Pylori or Epstein Barr)
• Gut pathogens (yeast, SIBO)
• Intestinal permeability (leaky gut)
• Stress
• Environmental toxin exposure like mold, mercury, glyphosate, and copper.
• Hormonal shifts

You may be noticing that many of these potential contributing factors are very similar to the ones we speak about in Hashimoto’s triggers because the issue here is the immune system that is confused.

Integrative Support for Graves' Disease

Some integrative doctors will recommend supplements aimed at supporting the slowing down of the thyroid. They may also recommend supplements to reduce the risk of worsening health issues caused by the symptoms of Graves' disease like depleted calcium.

In addition, testing for and supporting underlying issues may reduce Graves' symptoms. Juli shared an example of a patient who was taking excessive amounts of spirulina believing increased amounts of a health product would result in increased health benefits. Instead, the high doses of spirulina resulted in an overload of iodine which even further increased thyroid function. This is why it’s important to look at the whole picture.

Additionally, patients typically see that dealing with dysbiosis, adrenal imbalances, H. Pylori infections, or removing toxins from their day to day environment reduce their symptoms and help calm the immune response.

These are positive steps to take and getting to the root cause of what is creating the immune response my be able to reduce the chances that the thyroid will need to be removed or destroyed. These options however should be considered with the guidance of an endocrinologist and (ideally) also a functional medicine doctor.

Testing for Triggers and Contributing Issues

Finding what may have triggered a symptom or lead to Graves' disease can be a real health mystery. Juli likes to test for viruses when she is on the hunt for a root cause. She will run a variety of tests looking for antibodies to see if there is an active virus. This viral panel will also reveal if  Epstein Barr Virus might be at play.

Treating Triggers and Potential Root Causes of Graves' Disease

Treating triggers and dealing with potential root causes may require a combination of integrative health and conventional medicine solutions. For example, Juli explains that antiviral medication sometimes just works faster including valacyclovir and acyclovir.

Additionally, correcting any mineral deficiencies...