Graves’ Disease: Therapy

General measures

  • In case of orbitopathy (protrusion of the eyeballs) – use artificial tears and tinted glasses with side shields if necessary and, if possible, adopt a relatively upright sleeping position; furthermore, the eyelids can be taped shut during sleep (watch glass bandage).
  • Nicotine restriction (refrain from tobacco use) – smoking cessation is to be aimed for! Smoking increases the risk of recurrence (recurrence) of Graves’ disease and promotes the progression (progression) of endocrine orbitopathy (EO).
  • Avoidance of psychosocial stress:
    • Stress

Conventional non-surgical therapy methods

  • Radioiodine therapy (RJT) is a procedure in which the thyroid gland is progressively destroyed by radioactive radiation. It can be performed as initial therapy (in case of side effects of the drug, persistently high need for thyrostatic drugs) or as therapy in case of recurrence that has occurred. Another indication is the contraindication (counterindication) of surgical therapy of hyperthyroidism (hyperthyroidism). The success rate of radioiodine therapy is about 90%. The thyroid volume decreases under therapy by about 20 ml.For more see below “Radioiodine therapy“.
  • Retrobulbar irradiation (X-ray irradiation of the tissue behind the eyes) in exophthalmos: orbitaapex is irradiated from the temple, leaving out the cornea (lenses) with a total dose of 20 Gy in ten fractions over two weeks (contraindication: diabetes mellitus). Note: The success of therapy is shown with a latency of up to 6 weeks; after about 4 to 6 months, one can finally assess the treatment.In severe cases, an orbital decompression (see below Exophthalmos/Operative Therapy (Ultima Ratio Therapy).
  • Prism prescription (foils, glasses) – to improve disturbing double images; if necessary, also consider monocular occlusion (covering a single eye).

Regular check-ups

  • Regular medical checkups

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grain products).
  • Observance of the following special dietary recommendations:
    • Since a high iodine intake can be one of the causes of Graves’ disease, the daily intake of iodine should not exceed the intake recommendations (reference value for the recommended iodine intake of the German Nutrition Society (DGE) for a healthy adult: 180-200 µg/day).
  • Selection of suitable food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Psychotherapy