Guest Author - Jim Lowrance
Graves' disease is an autoimmune thyroid disorder that requires treatment by medical professionals. The disease causes the thyroid gland to produce excessive amounts of hormone, causing an over-active metabolism.
Graves’ disease (GD) causes an overactive thyroid gland (hyperthyroidism), so the purpose of treatment is to bring thyroid function back to a normal level. An overactive thyroid gland resulting from GD causes too much thyroid hormone to be produced and distributed throughout the body. This will result in an overactive metabolism and in all bodily functions being abnormally sped up. The goal of treatment for GD is to reduce the over-activity of the thyroid gland, so that it is operating at a range considered to be within normal limits. For a list of symptoms caused by this disease, see my article about recognizing Graves’ disease.
Anti-thyroid medications are used to slow production of thyroid hormones. The thyroid gland produces mainly the “T-4 and T-3” hormones, but people with GD will have increased production of these as a result of the autoimmune response within the body that causes the disease. Patients will be given a trial of an anti-thyroid medication, which is designed to slow down the overactive thyroid so that thyroid hormones fall within normal values. Two of the more common brands of anti-thyroid medications are methimazole (Tapazole) and propylthiouracil (PTU).
Beta-blocker medications may also be used to control some of the symptoms of hyperthyroidism caused by GD. Beta-blockers, commonly prescribed for high blood pressure, are drugs that block the effects of adrenaline, the hormone sent out by the adrenal gland that helps stimulate heart rate and blood pressure regulation. Patients with GD may have increased heart rate (tachycardia) and increased blood pressure (hypertension), so administration of a beta-blocker as part of their treatment regimen may sometimes be used to control these abnormally high functioning bodily responses. Some GD patients may only be treated with a beta-blocker or only with an anti-thyroid medication, while some may be treated with both medications simultaneously.
Patients who have GD that cannot be controlled well using oral medications may need their thyroid gland surgically removed or destroyed through radiation treatment. When a GD sufferer has such severe symptoms, their doctor may refer them to a surgeon for partial or total removal of their thyroid gland. The names for these surgeries are “Total Thyroidectomy” (entire gland removal) and "Subtotal Thyroidectomy" (partial gland removal). Once this surgery has been performed, there is less or none of the thyroid gland in the patient’s body to over-produce thyroid hormones. The same is true of “Radioactive Iodine” treatment (also called “ablation”) that is also used to destroy the thyroid gland, rather than removing it surgically. Patients afterward have no thyroid gland in their bodies and so become hypothyroid (low thyroid hormone) following removal or ablation. With both types of thyroid removal treatments, the patient will have to be replaced lifelong with the missing hormone, through “Thyroid Hormone Replacement Therapy” medication.
When GD patients develop “Graves’ ophthalmology”, this will also need to be treated. Graves' ophthalmology (GO) is a co-occurring inflammatory condition affecting the eyes (also called Thyroid Eye Disease). It can potentially develop in GD patients and can cause bulging of the eyes and possible deterioration of vision. The most common treatments for GO include:
Eye drops to keep the eyes lubricated
Corticosteroid therapy (steroid anti-inflammatory)
Radiotherapy and/or Decompression Therapy to reduce orbital damage
Eyelid surgery, to lengthen eyelids that may not cover the eyes well, due to them bulging.
GD patients who smoke are sometimes also recommended by their doctors to quit smoking because of the inflammatory chemicals contained in cigarettes that can potentially affect the eyes.
These are general overviews of some more common treatments for GD. Patients with the disease are evaluated by licensed physicians, so that the treatment is tailored to each of them individually.