How Graves' Disease Is Treated

Graves' disease is an autoimmune disease of the thyroid, the butterfly-shaped organ in the front of your neck. It's caused by a malfunction of the thyroid gland, leading to the overproduction of thyroid hormones. Graves' disease is the most common cause of hyperthyroidism in the United States.

Common therapeutic options include antithyroid drugs, radioactive iodine therapy, and thyroidectomy (the removal of the thyroid). Some complementary and alternative medicines have also been known to help alleviate symptoms of this condition.

This article will outline medications, procedures, home remedies, and dietary changes that are helpful to treat Graves' disease.

Prescriptions

There are antithyroid medications that people can take to alleviate symptoms of Graves' disease. Tapazole (methimazole), propylthiouracil, and Neo-Mercazole and Anti-Thyrox (carbimazole) are all medications that block the thyroid gland from producing too much thyroid hormone.

People with Graves' disease may be prescribed immunosuppressive drugs, which keep your immune system from attacking itself, such as oral corticosteroids. Steroids stop the body from making cytokines (which regulate the body's response to disease and infection) that cause inflammation.

Radioactive Iodine Therapy

Radioactive iodine therapy (RAI) treats Graves' disease by damaging or destroying thyroid cells through radiation. This may sound concerning but it is generally safe. During this procedure, you are given a pill to swallow. You will be instructed to drink a lot of water to flush the remaining radioactive iodine out of your system. You may experience a temporary change in taste.

RAI is a one-time therapy for most people. If symptoms persist for six months or more, you may need a second dose.

People with thyroid eye disease or exophthalmos (bulging of one or both of the eyes) are not candidates for radioactive iodine therapy. Additionally, people who smoke have very high risk of developing thyroid eye disease after radioactive iodine therapy.

Thyroidectomy

Thyroidectomy is a medical procedure where a surgeon removes the entire thyroid. This may cure hyperthyroidism but there is a risk that it will cause hypothyroidism (underactive thyroid), which requires lifelong medication with Synthroid (levothyroxine).

Prior to surgery, you will have blood taken, scans such as computerized tomography (CT) or magnetic resonance imaging (MRI), and have your vocal cords examined using an instrument called a laryngoscope.

Thyroidectomy can be performed through an incision at the front of the neck, or through the mouth. The first can cause permanent scarring.

Possible complications of the surgery include:

• Voice changes, such as hoarseness
• Sore throat
• Bleeding and blood clots
• Adhesions or scar tissue that require surgery
• Injury to the esophagus or windpipe

Home Remedies and Lifestyle

Eye symptoms associated with Graves' disease such as dryness and swelling can often be treated at home. Home remedies include:

• Using a cold washcloth on your eyes provides extra moisture if your eyes feel dry.
• Eye drops can help relieve dryness and scratchiness.
• Elevating your head in bed can reduce swelling around the eyes.
• Wearing sunglasses can reduce your exposure to light if your eyes are sensitive.

Dietary Considerations

Graves' disease can affect your digestion and weight. What you eat can help alleviate some digestive discomfort. Eating a low-iodine diet is important to increase the effectiveness of radioactive iodine therapy. The following foods are low in iodine:

• Fresh fruits like berries and avocados
• All vegetables
• Fatty fish like salmon
• Beans (if canned, choose the low-sodium or salt-free options)
• Whole grains such as oatmeal and brown rice
• Nuts
• Chia and flax seeds

Try to avoid overly processed foods and caffeinated drinks like coffee and tea. Caffeine can interfere with the effectiveness of some medications, but caffeine-free coffee and tea are fine to enjoy.

Supplements

There are a variety of supplements that may benefit people with Graves' disease. These include:

• Selenium: This is a mineral that plays a role in metabolism and brain function. Iodine, the key ingredient of the thyroid hormone, requires selenium to be synthesized properly into thyroid hormone. Selenium is the only supplement that has consistently proven to benefit people with Graves' disease.
• Vitamin B-12: Vitamin B-12 is present mainly in animal products, including meats, dairy and eggs. You can take supplements in pill form or by injection (by a medical doctor), which may boost energy levels if you have a B-12 deficiency (which is more common in people with autoimmune thyroid conditions).
• Iron: Graves' disease interferes with iron metabolism. If you are not able to get enough iron in your diet with foods like leafy greens, nuts, or red meat, a supplement may help.
• Lemon balm: Preliminary studies have shown that this member of the mint family may calm an overactive thyroid; however, more research is needed. 
• L-carnitine: Some research has suggested that this substance can reduce symptoms associated with an overactive thyroid. 

Summary

Graves' disease can be treated with various medications and procedures, including radioactive iodine therapy and thyroidectomy. Complementary therapies such as dietary changes, supplements, and at-home symptom management can also help alleviate symptoms. Always check with your healthcare provider before trying a new supplement, diet, or home remedy, as it may interfere with your current treatment plan.

A Word From Verywell

Graves' disease is a treatable condition that can be supplemented with at-home care. Over time, your condition can go into remission, meaning you may become asymptomatic or even be cured of it altogether. If your symptoms worsen, call your healthcare provider to have an exam and see if another treatment plan can help.