From the Guidelines
A good lifestyle for a patient with Graves' disease should prioritize a balanced diet, regular physical activity, stress management, and adequate sleep to manage symptoms and support medical treatment. According to the most recent study 1, optimizing lifestyle can improve the quality and quantity of life, even in persons with multiple risk factors and comorbidities. Key aspects of a healthy lifestyle for Graves' disease patients include:
- A balanced intake of nutrients, with consumption of fruits, vegetables, whole grains, lean poultry, fish, and legumes, while discouraging processed foods and those with excess saturated fat, salt, and sugar
- At least 150 minutes per week of moderate-intensity aerobic plus resistance activity, with any type or amount of physical activity being useful
- Stress management through positive practices such as mindfulness and engagement with social activities, as stress can worsen symptoms
- Adequate sleep, usually 7-9 hours nightly, to decrease the risks of insulin resistance, hypertension, hyperglycemia, and dyslipidemia
- Smoking cessation, as it is the single most important component of lifestyle therapy, and limiting excess alcohol intake to no more than 1-2 daily drinks per day. Additionally, patients with Graves' disease may benefit from beta-blockers such as propranolol to manage symptoms like increased heart rate and tremor, as discussed in 1. However, the most recent and highest quality study 1 provides the foundation for lifestyle recommendations, prioritizing a holistic approach to managing the disease.
From the Research
Lifestyle Interventions for Graves' Disease
- A case report published in 2019 2 demonstrated that a patient with Graves' disease was able to normalize her thyroid hormones and autoimmune markers in 6 months through lifestyle interventions, including:
- Dietary changes to an ancestral type of diet
- Oral health interventions
- Practice of kundalini yoga
- Avoidance of environmental toxicants
- Supportive supplements when necessary
- This case report suggests that a healthy lifestyle can be an effective first-line intervention for patients with Graves' disease.
Treatment Options for Graves' Disease
- Established treatment modalities for Graves' disease include antithyroid drugs, radioactive iodine, and surgery 3, 4, 5, 6
- However, these treatments may have limitations and side effects, such as:
- Antithyroid drugs: risk of rare but serious adverse effects, including agranulocytosis and hepatitis 4, 5
- Radioactive iodine: risk of permanent hypothyroidism and exacerbation of pre-existing ophthalmopathy 4, 6
- Surgery: risk of complications, including hypoparathyroidism and permanent paralysis of the recurrent laryngeal nerve 4
Emerging Therapies for Graves' Disease
- Recent advances in understanding the pathogenesis of Graves' disease have led to the development of new target-based therapies, including:
- Monoclonal antibodies, small molecules, and peptides that target the thyrotropin receptor or block the immune pathway 3, 6
- Therapies that block pro-inflammatory cytokine receptors, lymphocytic infiltration, or the insulin-like growth factor 1 receptor (IGF1R) for the treatment of Graves' orbitopathy 3