Functional Medicine Solutions For Graves Disease- Part 2

SOLUTIONS TO GRAVES’ DISEASE:  The solution to Graves lies in:

• Healing the gut
• Identifying the environmental trigger(s)
• Addressing ALL causes of inflammation to calm the immune system and prevent the autoimmune attack

One incredible case study from 2019 demonstrates how a 34-year-old woman healed Graves disease through natural approaches using diet and lifestyle (Brogan K, 2019). Here are key elements of her treatment plan (Brogan K, 2019):

• An Ancestral Diet, similar to the Paleo diet: This diet eliminates refined carbs and sugars, processed foods, gluten, most grains, dairy, soy, corn and focuses on what our ancestors ate; wild fish, clean organic meats, eggs, fruits, vegetables, nuts and seeds.
• Oral Health Care using oil pulling and Hydro Flosser: Oil pulling is an ancient Ayurvedic tradition that detoxifies both the mouth and the body. Dental health impacts overall health. A Hydro Flosser uses water to floss and produces better results than string flossing (Brogan K, 2019).
• Yoga, Exercise and Meditation: Tremendous benefits come from yoga, exercise and meditation including reduced stress, anxiety and depression, a decrease in blood pressure and cortisol levels, increased mindfulness and an improvement in pre-existing conditions such as arthritis and cancer (Brogan K, 2019).
• Avoidance of Environmental Toxins (purified water, organic food, natural cleaning & personal care products): Toxins are detrimental to thyroid health. By focusing on clean water, clean food and clean products, this case study subject was able to heal from Graves (Brogan K, 2019).
• Supplements: It is important to check certain nutrient levels for optimal thyroid health. The nutrients that were supplemented in this study are iodine, iron, selenium, zinc, vitamins A, C, D, B complex, mineral support and probiotics (Brogan K, 2019).

DIET FOR GRAVES’ DISEASE:

We recommend a few possible diets for Graves. The key is that the diet be nutrient-dense, whole foods based and anti-inflammatory. Certain diets work better for certain individuals so you may have to experiment a little to find a best diet for your health. Diets to explore are:

• The AutoImmune Paleo diet or AIP
• The Paleo diet, similar to the Ancestral diet mentioned above
• The Gluten-free Mediterranean diet

A few specific diet recommendations that can help:

Avoid soy as it has been shown to have negative effects on thyroid health.

Don’t consume excess iodine and focus on low iodine foods. Too much or too little iodine is a problem and it is important to get the correct amount. Avoid the high iodine foods: seaweed, dairy, tuna, shrimp, eggs, iodized table salt. Some medicines, for example the heart medicine amiodarone, and cough syrups, may contain a lot of iodine (National Institutes of Health, 2016). In working with your FM practitioner, test your iodine levels through a urine test, which is the most accurate. This way, you can be sure to target the correct iodine level for you.

Go gluten-free. Gluten is an issue for thyroid health due to its impact on the gut lining and leaky gut, as well as its molecular mimicry with thyroid tissue.

For more details on why soy, gluten and iodine should be avoided, please read our article on gluten and iodine. This article in our Thyroid Series explains why soy should be avoided.

SUPPLEMENTS FOR GRAVES’ DISEASE:

There are a number of supplements that can help with Graves. It is important to work with your FM practitioner to test nutrient levels and then address any deficiencies.  

• We recommend a urine test to check iodine levels. If your levels are low, then you can eat high iodine foods and/or supplement iodine. If your levels are high, then focus on low iodine foods.
• Very high dose iodine can suppress excessive thyroid hormone but this is not recommended to do on your own! Be sure to get the guidance of a skilled FM practitioner who is monitoring labs and iodine levels.
• Selenium, zinc, iron and vitamin D are other key thyroid nutrients. Test your levels and make sure you are getting enough of these nutrients for good thyroid health.
• In addition, thyroid-calming herbs such as bugleweed, motherwort, and lemon balm can calm an overactive thyroid. 
• A high-quality multi-vitamin & mineral supplement can help you get the right levels of important nutrients such as vitamin B complex, A and C, as well as important minerals.
• For immune regulation, it is helpful to add the supplements glutathione, curcumin and fish oil or cold-water fatty fish consumption (wild salmon, anchovies, sardines, herring, etc.)
• Acetyl-L-Carnitine inhibits both T3 and T4 entry into the cell nuclei (Benvenga S, 2004), inhibiting the action of thyroid hormones. In a randomized trial, 2 and 4 grams per day of oral L-Carnitine were capable of reversing hyperthyroid symptoms (Benvenga S, 2004). Maintaining enough L-carnitine helps to keep thyroid hormones out of the cells (Benvenga S, 2004). For Grave’s, with elevated thyroid hormone levels, 2-4 g Acetyl-L-Carnitine per day can lower thyroid hormone levels.
• Low Dose Naltrexone (LDN) is a generic drug originally designed for withdrawal from opioids. It is now used off-label for other conditions, often autoimmune in nature (Toljan K, 2018). LDN re-balances the immune system and reduces the inflammatory response by modulating immune cells (Toljan K, 2018). At a dose of 2-3 mg per day, it can be helpful in many cases of Hashimoto’s or Graves.

OTHER SOLUTIONS to support the thyroid and address Graves’ Disease are:

Heal the Gut: Work with a FM practitioner to improve gut health. Identify any infections, overgrowths or other issues and resolve them. It is critical in autoimmunity to resolve leaky gut. This can be done with diet and supplements. Once the gut is healed, nourish the good gut bacteria with a healthy diet, lifestyle habits and pro- and prebiotics.

Boost immunity: By healing the gut you will automatically be boosting immunity as 70-80% of the immune system is located in the gut. You can further boost your immune strength by testing vitamin D levels. The ideal level is around 50-60 ng/ml.

Address infections: It is critical to address any underlying chronic infections like Epstein Barr Virus, or other viral or bacterial infections.

Stress management: We can never eliminate all stress. But we do need to learn to manage it through mindfulness practices like meditation, yoga, tai chi, deep breathing exercises, other types of movement, listening to music and other ways to get into the parasympathetic state of the nervous system.

HPA (hypothalamus-pituitary-adrenal) axis support: With your FM practitioner, you can assess for HPA axis dysregulation. The HPA axis may contribute to thyroid symptoms (Wellwood C, 2014). It is important to treat the adrenals and thyroid in combination. If you are very stressed, the HPA axis will likely be dysregulated and will require some support.

Reduce toxin exposure: Decrease the amount of toxins that come into your body. Don’t smoke, drink minimal alcohol, eat an organic diet and reduce exposures to chemicals and pesticides. Clean up your personal care/ cosmetic products & household products; use the EWG skin deep website to check products at https://www.ewg.org/skindeep. Use clean cookware and not Teflon. Avoid the chemical fluoride in tap water and toothpaste. Drink filtered water and get a shower filter. Add houseplants to absorb chemicals in the environment. Reduce EMF’s exposure where possible. Reduce exposure to bromide, which is especially high in supermarket breads. Reduce exposure to chlorine with a shower filter and minimal exposure to swimming pools.

Support the liver & detoxification: This is an important step to help detoxify toxins and chemicals. You can work with an experienced FM practitioner to take steps to detoxify. If there is a case of excess heavy metals or other toxic exposure, this will be a key step to healing your thyroid. There are supplements that can help like glutathione and others. Diet changes can help to reduce toxic load. Other practices like sweating, using a sauna or far infrared light exposure (see our article here), drinking plenty of clean, filtered water and exercising regularly are important. You can test your liver function by looking at liver enzyme (AST, ALT, GGT) levels.

Remember the basics: Be sure to work on important lifestyle factors and ensure that you sleep well, exercise and meditate to manage stress!

** Thank you for reading about Graves’ Disease. Please check our blog next week to read our next topic in the Thyroid Series on **

Thyroid Nodules