Thyroid health is a major focus, and understandably so. About 20 million Americans have thyroid disease, with up to 60% with thyroid issues unaware of their condition. Women face a higher risk, with one in eight developing a thyroid disorder in their lifetime. While less common than hypothyroidism, hyperthyroidism is equally essential to diagnose and treat. It affects 1 in 100 Americans over age 12 and can lead to serious issues if untreated.
Graves' disease, an autoimmune disorder, is a key cause of hyperthyroidism. This disorder comes about when the thyroid gland produces excessive thyroid hormone, which regulates body temperature, heart rate, and metabolism. An overactive thyroid can harm organs like the heart, bones, and muscles. However, with comprehensive care that involves regular testing, this condition can be effectively managed so patients with Graves' can lead healthy and productive lives.
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What is Graves' Disease?
Graves' disease is considered an autoimmune disorder in which one's immune system mistakenly targets the thyroid gland, resulting in excess thyroid hormone. The thyroid is a small, butterfly-shaped gland in the neck. It regulates metabolism, the rate at which the body converts food into energy, along with other essential body functions such as heart rate, body temperature, and brain health. In Graves', when the immune system attacks the thyroid, this unbalanced response leads to an overactive thyroid, called hyperthyroidism, that speeds up all those body functions.
What Causes Graves' Disease?
Graves' disease arises when the immune system mistakenly generates antibodies targeting the thyroid-stimulating hormone (TSH) receptor on the thyroid gland. Although TSH typically binds to this receptor to prompt thyroid hormone production, these antibodies imitate TSH behavior. Consequently, they activate the receptor, leading to an overactive thyroid. This condition results in an enlarged thyroid gland (goiter) and heightened hormone release.
Several factors contribute to the development of Graves' disease. These encompass genetics, environmental exposures, infections, and imbalances in gut health.
Genetics play a role, as specific immune-related genes increase susceptibility. These genetic factors interact with environmental and epigenetic elements to influence disease development.
Environmental factors also contribute to the condition. These include endocrine-disrupting chemicals, heavy metals, smoking, stress, radiation, and infections. Exposure to such substances can lead to inflammation and autoimmune responses. Some chemicals interfere with iodine in the thyroid, impacting its function. Smoking and stress, on the other hand, can trigger the onset of disease and exacerbate the symptoms. Infections, such as HSV, rubella, mumps, and EBV, are another potential to trigger autoimmune thyroid disease.
Gut health significantly impacts the immune system, with imbalances in gut microbes and a compromised gut barrier increasing the risk of autoimmunity. Disruption in the gut microbiome and barrier can occur due to chronic exposure to toxins, inflammatory foods, and stress. When the barrier becomes permeable, harmful substances can enter the body, provoking inflammation and autoimmunity, including Graves' disease.
Nutrient levels are another consideration when it comes to risk factors for developing Graves' disease. For instance, a lack of Vitamin D could worsen the initiation and progression of this disease. However, rectifying this deficiency might have the potential to reverse the condition.
Graves' Disease Symptoms
In Graves' disease, the immune system's attack on the thyroid gland generates excessive thyroid hormones, triggering various bodily functions to accelerate and become imbalanced. As thyroid hormones affect the entire body, the symptoms of Graves' disease can have widespread effects. It's important to note that around 30% of individuals with Graves' disease experience eye problems, often as Graves' ophthalmopathy. This condition stems from inflammation and the buildup of specific carbohydrates in the eye muscles and tissues. It leads to symptoms like eye bulging, pressure behind the eyes, gritty eye sensation, light sensitivity, and vision changes.
Other common symptoms include:
● Weight loss
● Increased appetite
● Rapid or irregular heartbeats
● Tremors
● Thickened, reddened skin on shins or feet (Graves' dermopathy)
● Fatigue or tiredness
● Weakness in the muscles
● Sensitivity to heat, hot flashes, and sweating
● Trouble sleeping
● Anxiety
● Irritable mood
● Digestive changes like frequent stools, loose stool, or diarrhea
● Altered menstrual cycle
● Reduced sex drive
● Decreased bone density and osteoporosis
Importance of Regular Lab Testing for Graves' Disease Patients
Regular testing is crucial for patients with Graves' disease because many factors can trigger an autoimmune response, thus aggravating the condition. Another reason is that many people are unaware of their condition, potentially leading to more severe or worsening issues. Testing can enable those unaware to address any underlying factors causing their symptoms adequately. Retesting thyroid hormones 6-8 weeks after adjusting the thyroid protocol is also advisable. Once thyroid levels stabilize, testing can be done once or twice a year to optimize their levels and wellness if the patient's condition remains steady.
Top Labs To Run Bi-Annually on Your Graves' Disease Patients
The following functional labs are run regularly by clinicians to help effectively manage Graves' Disease for their patients:
Comprehensive Thyroid Panel
To assess thyroid function, a complete thyroid panel should be conducted through a serum sample. This test includes evaluating TSH, free and total T3, free and total T4, and reverse T3 using functional medicine ranges. TSH reflects the communication between the brain's pituitary gland and the thyroid, with decreased levels indicating hyperthyroidism.
Free T4 is unbound thyroid hormone availability, indicating increased thyroid function when elevated. T4 converts to T3 in peripheral tissues, and heightened T3 levels suggest heightened thyroid function. Additionally, thyroid antibody testing, especially for thyrotropin receptor antibody (TRAb), aids in diagnosing Graves' disease.
Some individuals with Graves' disease might also develop Thyroid Peroxidase (TPO) or antithyroglobulin antibodies. These antibodies are usually associated with Hashimoto's hypothyroidism. It's crucial to run the thyroid panel regularly for Graves' disease patients to ensure their thyroid hormone levels stay stable.
Environmental Toxin Screen
Environmental toxins are ubiquitous, with more than 80,000 of them potentially causing harmful effects when we're exposed. Chemicals and heavy metals, for instance, can trigger Graves’ disease. Tracking toxin levels through regular testing helps healthcare providers identify exposure and aid patients with associated symptoms. The outcomes provide insights for protocols to lessen the toxic load.
Advanced Adrenal Stress Test
Elevated stress levels have been shown to trigger the onset of Graves' disease in genetically susceptible people. Healthcare professionals can assess a patient's stress response by measuring cortisol, a stress hormone. This evaluation helps identify if imbalances are contributing to the disease's onset or severity. The adrenal stress test analyzes cortisol levels from saliva samples taken at different times during the day, offering a comprehensive view of the patient's stress response. As stress levels fluctuate, routine tests can assist in managing these changes, enhancing the patient's outcomes. The results of this test assist providers in helping patients design tailored protocols to address their stress levels.
Vitamin D Testing
Evidence suggests that insufficient Vitamin D levels can trigger the development of Graves' disease. Addressing this deficiency could hold the possibility of reversing the condition that's associated with this nutrient deficiency. Checking for Vitamin D levels is completed by a blood sample. It can help practitioners target supplement protocols to optimize Vitamin D levels for patients at risk for Graves' disease. Retesting can help to monitor these levels and the effectiveness of the dosing protocol.
Additional Labs to Check
Other labs to consider for Graves' disease include a Radioactive Iodine Uptake (RAIU) and an Ultrasound (US). The RAIU test involves a low dose of radioactive iodine (I-131) to assess the thyroid's iodine absorption and pattern. High iodine uptake indicates Graves' disease. On the other hand, the US of the thyroid helps rule out other causes of an overactive thyroid. This imaging uses sound waves to check for thyroid enlargement and nodules.
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Summary
60% of thyroid patients may be unaware that they have a thyroid condition. They may present with symptoms such as heart palpitations, nervousness, weight loss, or difficulty sleeping. A comprehensive evaluation through functional lab testing can be essential. These tests can provide guidance on the right health path to take so you and your patients can address those symptoms before they become more severe. Helping your patients understand the risks and contributing factors to their condition can help in effectively managing and treating the condition. Regular lab testing can help you monitor those treatments to optimize them specifically for your patient's health needs.
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