Diseases

Graves' Disease Information

Foods (diet) to avoid if you have Graves' disease

People with Graves' disease may be sensitive to harmful side effects from iodine. Eating foods that have large amounts of iodine - such as kelp, dulse, or other kinds of seaweed - may cause or worsen hyperthyroidism. Taking iodine supplements can have the same effect.Talk with your health care professional about what foods you should limit or avoid, and let him or her know if you take iodine supplements. Also, share information about any cough syrups or multivitamins that you take because they may contain iodine.

Graves' disease definition facts written by Dr. Davis*

• Graves' disease is a thyroid condition that results from abnormal stimulation of the thyroid gland by a material in the blood referred to as thyroid stimulating immunoglobins (TSIs) that bind to and activate thyrotropin receptors.
• Graves' disease is the most common cause of hyperthyroidism in the US.
• Symptoms of Graves' disease include
  • goiter,
  • problems getting pregnant,
  • lighter menstrual flow and less frequent periods,
  • weight loss,
  • frequent bowel movements,
  • heart palpitations,
  • thinning hair,
  • brittle hair,
  • hand tremors,
  • problems sleeping,
  • heat insensitivity,
  • increased sweating,
  • eye changes (exophthalmos), and
  • reddening and thickening of the skin on the shins and top of the feet (pretibial myxedema).
• The cause of Graves' disease is thought to be related to many factors including genes, gender, stress, pregnancy, and possibly infections.
• Graves' disease affects both men and women; however, women are affected about 8- 10 times more often than men.
• Risk factors for Graves' disease are associated with other autoimmune diseases such as vitiligo, rheumatoid arthritis, Addison's disease, type 1 diabetes, pernicious anemia, and lupus.
• Tests to diagnose Graves' disease include thyroid function tests, radioactive iodine uptake tests, and tests to detect TSI's.
• Treatments for Graves' disease include radioactive iodine, antithyroid medications such as methimazole (Tapazole) and propylthiouracil (PTU), andbeta blockers; in some patients, surgery is done.
• Untreated Graves' disease can lead to thyrotoxicosis and its severe form, thyroid storm, heart problems, weak and brittle bones, and death.
• Poorly treated Graves' disease during pregnancy can cause problems for the woman such as preterm birth, miscarriage, heart failure, preeclampsia, and placental abruption.
• Poorly treated Graves' disease can cause health problems for a fetus or baby such as preterm birth, low birth weight, thyroid problems, and still birth.

Medications for Graves' disease

Beta blockersBeta blockers don't stop your thyroid from producing thyroid hormone but can reduce symptoms until other treatments take effect. These medicines act quickly to relieve many of the symptoms of hyperthyroidism, such as trembling, rapid heartbeat, and nervousness. Most people feel better within hours of taking beta blockers.Antithyroid medicationsAntithyroid therapy is the simplest way to treat hyperthyroidism. Antithyroid medicines cause your thyroid to make less thyroid hormone. These medicines usually don’t provide a permanent cure, but in some people, the effects last a long time after they stop taking the medicine. Doctors most often use the antithyroid medicine methimazole.Doctors usually treat pregnant and breastfeeding women with antithyroid medicine, since this treatment may be safer for the baby than other treatments. Doctors use propylthiouracil more often than methimazole during the first 3 months of pregnancy because methimazole may harm the fetus, although this happens rarely. Also rarely, propylthiouracil may affect the fetus, but any effects are less harmful than having uncontrolled hyperthyroidism during pregnancy.Once treatment with antithyroid medicine begins, your thyroid hormone levels may not move into the normal range for several weeks or months. The total average treatment time is about 12 to 18 months,7 but treatment can continue for many years in people who don’t want radioiodine or surgery to treat their Graves' disease.Antithyroid medicines can cause side effects in some people, including

• allergic reactions such as rashes and itching
• a decrease in the number of white blood cells in your body, which can lower resistance to infection
• liver failure, in rare cases

• Fever
• Constant sore throat
• Tiredness
• Weakness
• Dull pain in your abdomen
• Loss of appetite
• Skin rash or itching
• Easy bruising
• Yellowing of your skin or whites of your eyes, called jaundice

Radioiodine therapy for Graves' disease

For radioiodine therapy, you take radioactive iodine-131 (I-131) by mouth as a capsule or liquid. I-131, at a higher dose than the dose used for imaging tests, slowly destroys the cells of the thyroid gland that produce thyroid hormone. The dose of I-131 usually used for radioiodine therapy does not affect other body tissues. You take radioactive iodine-131 as a capsule or liquid.Although it's unlikely, you may need more than one radio-iodine treatment to bring your thyroid hormone levels into the normal range. In the meantime, treatment with medicines called beta blockers can control your symptoms.Almost everyone who has radioactive iodine treatment later develops hypothyroidism, or underactive thyroid, because the thyroid hormone-producing cells have been destroyed. However, hypothyroidism is easier to treat and causes fewer long-term health problems than hyperthyroidism. People with hypothyroidism can completely control the condition with daily thyroid hormone medicine.Doctors don't use radioiodine therapy to treat pregnant women or women who are breastfeeding. Radioactive iodine can harm the fetus' thyroid and can be passed from mother to child in breast milk.

Surgery for Graves' disease

The least-used treatment for Graves' disease is surgery to remove the thyroid gland. Sometimes doctors use surgery to treat people with large goiters, or pregnant women who are allergic to or have side effects from antithyroid medicines.Before surgery, your doctor will prescribe antithyroid medicines to bring your thyroid hormone levels into the normal range. This treatment prevents a condition called thyroid storm - a sudden, severe worsening of symptoms - that can occur when people with hyperthyroidism have general anesthesia.After surgery to remove your thyroid, you will develop hypothyroidism and need to take thyroid hormone medicine every day for life. After surgery, your doctor will continue to check your thyroid hormone levels and adjust your dose as needed.