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Graves' Disease

Autoimmune Thyroid Condition

What is Graves' Disease?

Graves’ Disease is an autoimmune condition that impacts the thyroid. The immune system produces antibodies that bind to the thyroid cells and mimic the action of the thyroid stimulating hormone (TSH).  As a result the thyroid produces excessive amounts of thyroid hormones, essentially pushing the processes that your thyroid controls into overdrive. 

Grave’s disease is often accompanied by swelling and protruding of the eyes and coarsening or reddening of the skin on the shins.


What factors contribute to Graves' Disease?

What are the symptoms of Graves' Disease?

  • Racing heart and/or heart palpitations
  • Weight loss
  • Irritability
  • Fatigue and insomnia
  • Brittle nails
  • Shakiness
  • Goitre (visibly swollen thyroid gland)
  • Diarrhoea 
  • Irregular menstrual periods
  • Hair thinning (or loss of hair)
  • Shortness of breath
  • Intolerance to heat (feeling hotter than others)
  • Hair thinning (or loss of hair)

Graves' Ophthalmopathy

Graves’ ophthalmopathy, also known as thyroid eye disease (TED), is an autoimmune inflammatory disorder affecting the eyes. It is characterised by upper eyelid retraction, lid lag, swelling, redness (erythema), conjunctivitis, and bulging eyes (exophthalmos). Approximately, 1 in 3 people who have Graves’ Disease develop it, however it is also seen in individuals with Hashimoto’s thyroiditis, or in those who are euthyroid.

The most common presentation of TED is eyelid retraction. Symptoms can include:

  • Unnaturally round eye appearance
  • Exposed white below or above the iris
  • Dry eye syndrome
  • Burning sensation
  • Redness
  • Excessive tearing
  • Impaired vision

Graves' Disease Testing and Investigation

The simplest and most accurate method for diagnosing hyperthyroidism is via blood tests. Levels of thyroid hormones thyroxine (T4) and triiodothyronine (T3) should be assessed, and one or both must be elevated for a diagnosis to be made. It is also advantageous to assess TSH levels, as the purpose of this hormone is to stimulate the production of thyroid hormones. If the pituitary gland senses the slightest excess in thyroid hormones in the blood, it will stop the production of TSH. Therefore, TSH levels will be low in individuals with hyperthyroidism.

However, each laboratory sets its own range, so there is no government standard and this is why different labs will have different ranges. Also, many factors may cause TSH suppression, which is a naturally fluctuating hormone. When unsure, it is warranted to run functional pathology, as similar symptoms may also be due to menopause, stress and adrenal issues, nervous system disorders, and poor glucose regulation. 

To differentiate whether an individual also has Graves’ disease, additional testing is necessary as the very same thyroid antibodies may be present in both Hashimoto’s and Graves!

  • Thyroid Stimulating Immunoglobulin (TSI) and Thyroid Receptor Antibodies (TRABS) are the main specificity tests, which contribute to the exophthalmos (bulging eyes) that is typical of Graves’ disease.
  • Thyroid Peroxidase Antibodies (TPO) can also be assessed, as their presence indicates that the immune system has attacked the thyroid. However, 5-10% of healthy individuals will test positive for TPO antibodies, thus this cannot be relied upon alone for a definitive diagnosis of Graves’ disease.

Other Testing Types

Thyroid Nuclear Scan

A thyroid nuclear scan is used to help determine the cause of the excess thyroid hormone. This scan involves injecting a small amount of radioactive substance into a vein in the arm. After 20 minutes, images are taken of the thyroid (neck) area by a special gamma camera that provides information about the function and structure of the thyroid gland. These images require about 20 minutes to take.

This scan can also help in distinguishing between benign (non-cancerous) and malignant (cancerous) thyroid nodules or lumps.

This scan uses a radioactive substance, so is not suitable for pregnant or breastfeeding women. Some other pre-existing conditions may also prevent you from having a radioactive scan. Your doctor can discuss this with you.

Thyroid Ultrasound

This is a non-invasive imaging method that uses sound waves to take pictures of the thyroid gland and surrounding neck structures such as lymph nodes. It allows measurements to be made of the size of the thyroid gland, and of any thyroid nodules together with a description of what the nodules look like.

Our Recommended Testing

From a Functional Health perspective, we are not trying to diagnose a disease but to understand how and why a thyroid may be malfunctioning. Therefore, further testing is used to under the complete picture behind the symptoms. We aim to treat the cause, not just the symptoms.

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Thyroid Profile


This panel tests 8 markers which is essential to understanding the function of your thyroid, your metabolism and any inflammation that is present in the body. This test is critical for sufferers of Graves’disease and is often run at regular intervals to assess treatment response.

Halide Profile


Bromide blocks iodine absorption in the body creating a state of ill health. Graves’ patients will need to avoid iodine if their levels are not under control, but at a corrective level, iodine may be used when autoimmune antibodies are in normal range under practitioner guidance.

Stress & Sleep Profile


Insomnia is a very common and disruptive symptom of Graves’ disease. When the thyroid is overproducing hormones, sleep and stress are large contributing factors to blood pressure changes, weight changes, poor digestion, blood sugar instability, and insomnia. Baseline testing is recommended. 

Sugar & Fat Storage


Graves’ disease is usually associated with tremors, poor blood glucose control, and a need for additional insulin production by the pancreas. This increases the risk of developing diabetes, metabolic syndrome, and further energy production complications. Our testing covers current and long-term markers.

Cardiovascular Profile


Cardiac effects of Graves’ disease include a faster heart rate, stronger heart contractions, increased blood pressure, and irregular electrical activity of the heart. This profile is an essential part of thorough screening.

Metabolic Markers


Graves’ disease may be a potential risk factor for metabolic abnormalities even in those with medication controlled thyroid levels. Metabolic Markers assess energy, metabolism, and detoxification and should be a part of a thorough workup.

Detox Profile


Deranged liver enzymes affecting detoxification of the body due to hyperthyroidism in Graves’ disease are not uncommon. The reported prevalence of liver biochemical abnormalities in patients with untreated thyrotoxicosis ranges from 15% to 76%.

Sex Hormone Profile


Hyperthyroidism due to Graves’ affects sex hormones in both men and women. This can impact menses, mood, libido, skin, and appetite. Researchers in China discovered that increased expression of estrogen receptors is strongly associated with the development of Graves’ disease.

Food Intolerance Profile


People with Graves’ disease are also more likely to have irritable bowel syndrome (IBS), diarrhea, food allergies, and food intolerances. Removing specific foods from the diet for a period of time according to a blood test reduces inflammation, and aids remission when used as a part of a healing program.

Treatment Options for Graves' Disease

Medical Treatments

Several treatments for Graves’ Disease exist which varies on several factors, such as age, health status, severity, and other current conditions and medications.

If your thyroid hormone production is too high, an anti-thyroid medication (carbimazole or propylthiouracil) may be given. This medication reduces the production of thyroid hormones. Regular blood tests will be ordered by your doctor to check hormone levels are returning to a normal range.

Radioactive iodine may be used to reduce thyroid hormone production by destroying some or all of the thyroid gland. This is a permanent alteration to the thyroid gland and non-reversible, and not a treatment we recommend unless all other approaches have failed.

For most patients, this is a single treatment, taken as a pill that releases radioactive iodine. The thyroid gland absorbs the iodine, and the radiation damages and destroys the thyroid cells.

f too much thyroid hormone is being produced by the thyroid gland which cannot be controlled by an anti-thyroid medication or radioactive iodine treatment, surgery is generally recommended. For Graves’ disease, surgery involves removing all the thyroid gland – ‘total thyroidectomy’, also called TT. After a total thyroidectomy, lifelong thyroid hormone replacement therapy (levothyroxine) will be needed so that your body gets enough thyroid hormone to keep functioning.

As with radioactive iodine treatment, due to the permanency of the operation, we would consider this as a last resort if other functional medicine approaches fail. Many patients who have had a TT discover better medication management when combining a functional medicine approach that focuses on nutritional therapy, herbal medicine, and diet intervention to live a healthier life.

Integrative Treatments

Graves’ disease treatment can be combined with natural medicine treatments for potentially better patient outcomes. Patients that work integratively like this experience fewer side effects to medical treatments, and experience better symptom management.

Some patients wish to try natural medicine first, before resorting to a permanent procedure such as a total thyroidectomy, in which case a fully holistic treatment model is designed for them based on current pathology, symptom picture, and history.

This preventative and holistic approach can reverse thyroid disease and avoid permanent thyroid procedures.

Common deficiencies that contribute to autoimmune thyroid disease include zinc, vitamin D3, magnesium, B12, and active folate (L-Methylfolate). A functional health practitioner can test for vitamin and mineral deficiencies so these can be adequately treated.

A gluten and dairy-free diet can help reduce inflammation and aid in reducing autoimmune antibodies. It is also useful to avoid any foods that specifically cause inflammation in your body (which can be detected by doing a food intolerance test).

Botanical medicines can also help in “immune modulation” – that is, to help the immune system recognise self- from foreign antigens, and stop attacking its own tissues. Generally, a holistic approach is required to treat Graves’ disease with natural medicine, which includes diet modification, stress management, and herbal medicine.

Adrenal support is essential to help reduce stress levels, as stress is a well-recognised driver of autoimmune disease. We run 3-point saliva testing to assess adrenal hormone function, and sleep/insomnia.

Struggling with fatigue, insomnia and heart palpitations?

Book a free 15-minute consult with one of our practitioners and find out how we can help you get your Graves’ Disease symptoms into remission and get you back to living your life to the fullest.