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| Hyperthyroidism |
Last updated: May 12, 2008 |
Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | Other conditions that may be present | It can lead to... | Recommendations
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As the leading cause of hyperthyroidism, Graves' disease represents a basic defect in the immune system, causing production of immunoglobulins (antibodies) which stimulate and attack the thyroid gland, causing growth of the gland and overproduction of thyroid hormone. Similar antibodies may also attack the tissues in the eye muscles and in the skin on the front of the lower leg.
Facts - Graves' disease occurs in less that 1/4 of 1% of the population, but as many as 3% to 4% of asymptomatic populations have been found to have suppressed TSH levels suggestive of subclinical Graves' disease.
- Graves' disease is more prevalent among females than males.
- Graves' disease usually occurs in middle age, but also occurs in children and adolescents.
- Graves' disease is not curable, but it is a very treatable disease.
Who develops Graves' disease?
Although Graves' disease most frequently occurs in women in their middle decades (8 times more than men), it also occurs in children and in the elderly. There are several elements contributing to the development of Graves' disease. There is a genetic predisposition to autoimmune disorders and infections and stress play a part. Graves' disease may have its onset after an external stressor In other instances, it may follow a viral infection or pregnancy. Many times the exact cause of Graves' disease is simply not known. It is not contagious, although it has been known to occur coincidentally between husbands and wives.
How is Graves' disease treated medically?
The selection of treatment will include factors such as age, degree of illness, and personal preferences. Generally speaking, from least invasive to most invasive, the treatments include: - Anti-thyroid drugs that inhibit production or conversion of the active thyroid hormone (20-30% effective, often used to control mild cases)
- Radioactive iodine (I-131), which destroys part or all of the thyroid gland and renders it incapable of overproducing thyroid hormone
- Surgery, in which most of the thyroid gland is removed, renders it incapable of overproducing thyroid hormone.
The latter two treatments result in a 90-95% remission rate of the disease. In a few cases the treatments must be repeated. In all cases lifetime follow-up laboratory studies must be done, and in almost all cases lifetime replacement thyroid hormone must be taken.
What are the complications of the disease?
Graves' disease usually responds to treatment and, after the initial period of hyperthyroidism, is relatively easy to treat and manage. The more serious complications of prolonged, untreated, or improperly treated Graves' disease include weakened heart muscle leading to heart failure, osteoporosis, or possible severe emotional disorders.
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 Signs, symptoms & indicators of Hyperthyroidism: | | | | | | Lab Values - Common |  Rapid pulse rate
Counter-indicators:
 Slowed/normal pulse rate |
Lab Values - Hormones |
 Low TSH
High T3 free level
Elevated free T4
Elevated DHEA level
Counter-indicators:
 (Mildly) elevated TSH or normal TSH |
Symptoms - Bowel Movements |
 (Very) frequent stools or normal stool frequency
Having loose/having very watery stools
Counter-indicators:
 Having hard stools
(Very/tendency to) infrequent stools |
Symptoms - Cardiovascular |
Heart racing/palpitations |
Symptoms - Environment |
Poor tolerance of heat
Counter-indicators:
Good tolerance of heat |
Symptoms - Food - General |
Strong appetite |
Symptoms - General |
Fatigue on light exertion |
Symptoms - Head - Eyes/Ocular |
Bulging eyes
Vision disturbances
Irritated eyes
Counter-indicators:
Eyes bulge not from hyperthyroidism |
Symptoms - Metabolic |
Inner trembling
(Occasional) daytime sweating
Cold spells
Counter-indicators:
Low body temperature |
Symptoms - Mind - Emotional |
Inability to work under pressure
Irritability
Impatient/hostile disposition |
Symptoms - Mind - General |
Trouble concentrating |
Symptoms - Muscular |
Poor muscular strength |
Symptoms - Nails |
Brittle fingernails | Thyroid diseases may produce brittle nails or splitting of the nail bed from the nail plate. |
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Symptoms - Reproductive - Female Cycle |
Constant hot flashes or hot flashes between period |
Symptoms - Reproductive - General |
Weak sexual desire |
Symptoms - Skin - General |
Excess perspiration |
Symptoms - Sleep |
Unsound sleep
(Frequent) difficulty falling asleep |
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Conditions that suggest Hyperthyroidism:
Risk factors for Hyperthyroidism: | | | | | | Environment / Toxicity | Cigarette Smoke Damage| | A study of 132 pairs of twins (264 subjects) showed that smoking can have negative effects on the endocrine system, causing a 3- to 5-fold increase in the risk of all types of thyroid disease. The association was most pronounced in autoimmune disorders (Graves' disease and autoimmune thyroiditis), although there was still a strong association for non-autoimmune thyroid disorders. |
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Family History |
Hyperthyroidism in family members |
Lab Values - Chemistries |
Hypercalcemia| | In all the causes of hyperparathyroidism except high protein levels, elevated levels of ionized calcium occur also. |
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Lab Values - Hormones |
Having elevated TT4 level |
Nervous System |
Tremors| | Hyperthyroidism can cause tremors. If this is the case, then the hyperthyroidism must be treated, not the symptom of tremors. |
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Nutrients |
Copper Deficiency| | Although supportive data is limited, a report from a study group of hyperthyroid women suggests that copper status should at least be investigated in women with hyperthyroidism.
"Thyroid and immune system health are crucially dependent upon copper. As far as I can see now, copper deficiency is the most important factor in the development of hyperthyroidism. Virtually all hypers in the hyperthyroidism group have found that copper supplementation reduced their symptoms, usually within hours or a few days at most. Most have reported that within three to six months of beginning copper supplementation, they have been able to significantly reduce their intake of antithyroid drugs. While copper is the big story in hyperthyroidism, it is not the whole story. If it were, it would have been discovered years ago. Proper copper metabolism interrelates with and depends upon many other nutrients." [John Johnson, iThyroid.com] |
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Symptoms - Metabolic |
Recent unexplained weight loss
Counter-indicators:
Recent unexplained weight gain |
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Hyperthyroidism suggests the following may be present:
Hyperthyroidism can lead to:
Recommendations for Hyperthyroidism: | | | | | | Amino Acid / Protein |  L-Carnitine| | In a double-blind, placebo-controlled trial, 50 women with normal thyroid function were given thyroid hormone and randomly assigned to three groups: placebo for six months; placebo for two months followed by 2gm or 4gm per day of L-carnitine for months three and four, then placebo for months five and six; or 2gm or 4gm per day of L-carnitine for the first four months followed by two months of placebo. Clinical symptoms such as palpitations and biochemical parameters worsened when patients took placebo, and returned to baseline or improved minimally during L-carnitine treatment. Bone loss is normally experienced during a hyperthyroid state, but bone mineral density improved throughout the trial in all patients taking L-carnitine. The authors suggest the supplement may be useful for both preventing and treating hyperthyroidism. [J Clin Endocrinol Metab 2001;86(8): pp.3579-94] |
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Botanical |
Not recommended:
 Kelp / Seaweed| | Please see the link between Hyperthyroidism and Iodine. |
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Diet |
Caffeine/Coffee Avoidance| | Caffeine can worsen symptoms such as fast heartbeat, nervousness, and difficulty concentrating. |
 Gluten-free Diet| | Some doctors recommend the complete avoidance of gluten/gliadin and dairy products when this allergy is suspected in cases of Graves' disease or other autoimmune disease. |
Dairy Products Avoidance| | One doctor reports that taking calcium without magnesium is one of the worst things you can do if you have hyperthyroidism because this increases any magnesium deficiency and increases the heart rate and likelihood of arrhythmia. This is one of the reasons why dairy products, which are high in calcium and low in magnesium, need to be restricted until magnesium levels are replenished. |
 Therapeutic Fasting
Not recommended:
Raw Food Diet| | Most people who try a raw food diet for hyperthyroidism find it makes symptoms worse. However, I am aware of one person with hyperthyroidism who achieved a normal thyroid state on a raw food diet. |
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Drug |
Conventional Drugs / Information| | Because of the importance of controlling hyperthyroidism and preventing it's effects (on bone loss, for example), the use of conventional drugs to accomplish this should be considered strongly. |
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Extract |
Plant Sterols / Sterolins (Phytosterols)| | With Grave’s disease (hyperthyroidism), the body has become confused and sets up an autoimmune attack on the thyroid gland. When this autoimmune reaction is reduced, there is an opportunity for unhampered thyroid production and metabolism. Sterols and sterolins balance the immune system by decreasing the specific immune factor (Interleukin-6) responsible for the autoimmune reaction. As a result, thyroid function may be allowed to return to a more normal state. |
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Hormone |
Not recommended:
 Thyroid Medications |
Lab Tests/Rule-Outs |
Test Thyroid Function
Test for DHEA| | Some doctors report finding that a high percentage of patients with autoimmune disorders, such as Graves' disease, are also deficient in DHEA, and should be tested. |
Hydrochloric Acid (Trial)| | Some doctors report that 50% of patients with autoimmune disease are also hypochlorhydric. |
Test / Monitor Hormone levels |
Mineral |
Flouride| | Starting in the 1930s and continuing through to the late 1950's sodium fluoride was used to lower the activity of the thyroid gland for those suffering from hyperthyroidism.
For Many, 3-fluorotyrosine became the treatment of choice in hyperthyroidism. Within 6 to 8 weeks patients became symptom-free, and employment-ready. (1937) Litzka and May were able to document and supply evidence for all claims. Between Jan.1, 1935 and October 1936, May further cured 501 patients successfully with fluorotyrosine.
Around the same time (1932) Gorlitzer von Mundy, being aware that fluorides also get absorbed through the skin, began fluoride treatments of hyperthyroid patients in Austria by prescribing 20 minute baths containing 30ccm (0.03l) HF per 200 liters of water. He reported on his successful treatment spanning over 30 years and involving over 600 patients at a 1962 symposium on fluoride toxicity organized by Gordonoff in Bern, which was also attended by other world-leading experts including the great George Waldbott, Steyn, and others.
The fact is that in ALL cases but one, fluoride produced reduced plasma bound iodine, even at 0.9 mg/day - a fact of great importance when one considers the current knowledge on sub-clinical hypothyroidism. In ALL cases but 1 the Basic Metabolic Rate (BMI) decreased. This was achieved sometimes within 20 days. To evaluate this properly, one needs to understand how anti-thyroid agents work. It is well known in the field of endocrinology that PTU and Methimazole, the two drugs currently used in the treatment of hyperthyroidism, sometimes can take a few months to kick in, due to the thyroid storing large amounts of iodine. Galetti seems to complain about the fact that it took so long, concluding that it was "effective only occasionally among people subjected to massive doses of this substance" (This besides the fact that 6 of 15 patients were completely healed!...The average "massive" dose meaning 6mg NaF (2.9 F-) daily. One patient was clinically cured by 2.72mg F-/day over a period of four month period…
Flluoride is no longer used for hyperthyroidism treatement, only because there are stronger anti-thyroid drugs like Tapazole and PTU. However, treatment such as this might mean that one would not have to be on conventional medication for life.
May W - "Antagonismus zwischen Jod und Fluor im Organismus" Klin Wochenschr 14:790-792 (1935)
May W - "Behandlung der Hypothyreosen einschließlich des schweren genuinen Morbus Basedow mit Fluor" Klin Wochenschr 16:562-564 (1937)
Galetti, PM;Joyet, G - "Effect of Fluorine On Thyroidal Iodine Metabolism in Hyperthyroidism" J Clin Endocrinol 18:1102-1110 (1958) |
Selenium| | On June 22, 2001 Dr. Barbara Gasnier reported the findings at the 83rd Annual Meeting of the Endocrine Society in Denver, Colorado that selenium supplementation may prevent progression of autoimmune thyroid disease, especially during the onset of the disease.
According to the researchers, selenium deficiency appears to contribute to the development and maintenance of autoimmune thyroiditis because of its effect on the function of selenium-dependent enzymes, which can modulate the immune system.
Selenium supplementation with 200mcg of sodium selenite may improve the inflammatory activity seen in patients with autoimmune thyroiditis, but whether this effect is specific for autoimmune thyroiditis or may also be effective in other organ-specific autoimmune diseases remains to be investigated. Selenium supplementation may lower free radical activity, which contributes to inflammation.
It appears that taking selenium without iodine will result in a decrease in production of Thyroxine (T4), although there may be an initial transient increase in T4 to T3 conversion and hence higher T3 and seemingly worse hyperthyroidism. |
Copper| | A significant number of people with hyperthyroidism have reported improvement, even the absence of symptoms, after long term copper supplementation. Some felt better within hours of taking copper, and were eventually able to discontinue their antithyroid medication. On average, the body needs about 2.5 - 3mgs of copper per day. In hyperthyroidism, two to three times this amount (5 - 9mgs) per day is reasonable. |
Lithium (low dose)| | In 1972, Mayo Clinic researchers published the first clinical investigation of lithium treatment for Graves' disease. Using high-dose lithium for 10 individuals, they reported that thyroid hormone levels fell by 20-30% within five days.
Twenty-six years later, in a review of more than 10 successful trials of lithium therapy for Graves' disease, the authors wrote: "a small number of studies have documented its [lithium's] use in the treatment of patients with Graves' disease... it's efficacy and utility as an alternative anti-thyroid [treatment] are not widely recognized...". They also note lithium's rapid effect: "Lithium normalizes [thyroid hormone] levels in one to two weeks..." But they also caution that "toxicity precludes its use as a first-line or long-term therapeutic agent." Dr. Jonathan V. Wright, MD suggests that If they'd just added flaxseed oil and vitamin E to their treatment, they would have basically eliminated the risk of toxicity. |
Not recommended:
Iodine| | Iodine use is often contraindicated in hyperthyroidism. However, very high doses of Iodine for short periods (about thirty drops daily of SSKI for three weeks) have sometimes produced favorable results in Graves' disease. Because of the possibility of causing a 'thyroid storm' (an acute hyperthyroid state), this therapy should only be attempted under close supervision by a doctor experienced in its use. |
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Surgery/Invasive |
Surgery| | The type and cause of hyperthyroidism, along with symptoms will determine if surgery is necessary. You should work with a specialist to make sure the right course of action is being taken. Surgery is usually reserved for cases of cancer, enlargement causing difficulty swallowing, and where radioactive iodine was ineffective or where there were side effects to antithyroid medication. |
Neural Therapy| | Neural Therapy to the thyroid gland may help normalize its function and stabilize or shrink nodules. |
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KEY | | Weak or unproven link | | | Strong or generally accepted link | | | Proven definite or direct link | | | Weakly counter-indicative | | | Strongly counter-indicative | | | Very strongly or absolutely counter-indicative | | | May do some good | | | Likely to help | | | Highly recommended | | | May have adverse consequences | | | Avoid absolutely |
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