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Scott Benner 0:00
This show is sponsored today by the glucagon that my daughter carries. G voc hypo Penn. Find out more at G voc glucagon.com forward slash juicebox Hello friends and welcome to episode 641 of the Juicebox Podcast

Today's episode is a short one, it is also the second to last in the defining thyroid series. Today Jenny Smith and I are going to define Graves disease. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan are becoming bold with insulin. The defining thyroid theories began at episode 616 with hypothyroidism and Hashimotos thyroiditis. In episode 619. We defined pituitary and thyroid glands in Episode 624 T sh testing Episode 628, T four and T three and episode 632 auto immune episode 636 goitre episode 640 thyroiditis today in Episode 641 will be defining Graves disease. Then there's one more episode coming that episode number is 644 and it will be all about how to take your thyroid medication. G voc hypo pan has no visible needle, and it's the first premixed auto injector of glucagon for very low blood sugar in adults and kids with diabetes ages two and above. Not only is G voc hypo pen simple to administer, but it's simple to learn more about. All you have to do is go to G voc glucagon.com Ford slash juicebox. G voc shouldn't be used in patients with insulinoma or phaeochromocytoma. Visit G voc glucagon.com/risk. Can you just very quickly can we talk about Graves disease? Yes. All right. Well, I have always

Jennifer Smith, CDE 2:25
just ask and we'll talk about it.

Scott Benner 2:28
Nothing even years from now if I send you a note and I say Jenny, I just really want to talk about Graves disease, you'll say hold on I'll call you.

Jennifer Smith, CDE 2:36
Right I'll call you. Let's get on the

Scott Benner 2:39
phone and we'll chat about it. Well grave Graves is the one around thyroid that you don't hear about as much in my experience. But I have it here as Graves disease is caused by a malfunction in the body's disease fighting immune system so it's autoimmune. It is unknown why this happens. The immune system normally produces normally produces antibodies designed to target a specific virus bacterium or other foreign substance. But as we all know, once in a while it gets weird and goes after you

Jennifer Smith, CDE 3:10
which is so much fun and it does

Scott Benner 3:12
make my life perfect. It's an immune system disorder that results in the overproduction of thyroid hormones. That of course is called hyperthyroidism. Although a number of disorders may result in hyperthyroidism Graves' disease is a common cause thyroid hormones affect many blood systems so signs and symptoms of Graves disease can be wide ranging so Graves disease isn't isn't hyperthyroidism which is always how I had it mixed up in my head Graves disease is a thing that happens and then hyper hyperthyroidism comes from it. Am I understanding that right? Or no,

Jennifer Smith, CDE 3:50
I guess I mean, that's kind of a simplified, I guess. I'm trying to like digest what you just said to make sure. It's kind of like it's kind of like diabetes, right? Or type one diabetes specifically, right? I mean, it's the body's in auto immune system that is improperly doing something. And the result is a diagnosis of type one. So the result of the immune disorder and in Graves disease is specifically the immune disorder. That's named because your body over produces thyroid hormones, right hyperthyroidism? Essentially,

Scott Benner 4:38
I'm wrong about what I just said then so Graves disease is something that you that happens, it's autoimmune, and when it happens, you get hyperthyroidism. It's not like Arden got Coxsackie virus and then she got type one diabetes, it's Graves disease. It's not its own separate thing. Right, right. Okay.

Jennifer Smith, CDE 4:59
Yes. That's Yes, I'm good. Re Yes. redefinition there. Yes.

Scott Benner 5:04
Yeah, I'm just trying to understand it along because, you know, I have very simple brain I hear Graves disease, and I think, oh, they named it because it killed you. But I'm assuming probably some doctor that discovered it, but Right. But that

Jennifer Smith, CDE 5:16
I mean, Graves disease is a common. It's a common cause of hyperthyroidism, but it's not the only reason that you may have hyperthyroidism, right. Graves disease is specifically an immune system like an autoimmune disorder. Okay, one of the hype, one of the reasons for hyperthyroidism. So

Scott Benner 5:36
interesting. This You see, there's a first of all, by the way, Robert Graves, an Irish doctor who first described the condition in the 1800s, not because it put people in the grave, but I guess then all the diseases would be called Graves disease in the church, if that's

Jennifer Smith, CDE 5:52
especially those that had no treatment other than just, you know, go to bed and put a warm blanket on your body, I guess.

Scott Benner 6:00
He broke his knee, he's got Graves disease. So, you know, I'm going to give a couple symptoms here of it just because it's, you know, anxiety, irritability, a fine tremor of the hands or fingers, heat sensitivity, an increase in perspiration, warmer moist skin weight loss, despite normal eating habits, enlarged thyroid, which could be called a goiter, and a change in menstrual cycles are some common ways to know something's up, I'll tell you those things. In general, if those things are happening to you, my brain goes thyroid right away, they just write hair falls.

Jennifer Smith, CDE 6:42
And it's, and especially if you're a, a woman, again, most thyroid conditions are much more prevalent in women or in females than in the male population. Not that you can't be you know, male and have thyroid disorder, but it is much more common in women, and especially under the age of, I think it's under the age of 40 is much more common for it to, you know, come into play. And a lot of women especially around the time of a pregnancy, that change in hormones, especially in somebody who already has an autoimmune disorder to begin with. Much more common to have the potential for thyroid disorder, both hyper and hypo around that time to

Scott Benner 7:33
the bulging eyes are a real common sign of graves, right?

Jennifer Smith, CDE 7:37
It was something that was my mom's one of my mom's diagnostic along with obviously, you know, the goiter there's that word again, which we defined before. So no listen to

Scott Benner 7:50
everything was just sticking out of your mom's head. You guys thought something's wrong with mom. Yes, we

Jennifer Smith, CDE 7:55
were well, and we were I was it was actually after my before my brother was born. So I was my brother's younger than I am. So it must have been after I was born. So

Scott Benner 8:05
yes. So okay, so if you're seeing these symptoms, get to a doctor and then in the next episode, we'll explain how to how to take the medication because it's easy but you can miss time it and really take away from its effectiveness. Right. Am I making sense here? Yes. Yes. Good. Ah, hold on. See, Graves is one of those things like i don't i don't know like there's, you know what I'm saying right? Like there's, you get cancer, you have cancer, you lose weight, you your body dies, like cancer makes these things happen. But I know what cancer is. Right? I know that it's cells that are you know, that have mold doing the wrong thing. Wrong thing multiplied incorrectly, they've become diseased etc. I understand what cancer is. But I still don't in my heart know what Graves disease is.

Jennifer Smith, CDE 9:03
Yeah, I mean, I think it's just Graves disease is the autoimmune hyperthyroid sort of term, right? I mean Graves disease, you have hyperthyroidism, but the reason it is happening is because of your your immune system.

Scott Benner 9:21
So is Graves disease, the hyper thyroidism version of Hashimotos and Hashimotos

Jennifer Smith, CDE 9:28
is correct. They're both autoimmune derived, right?

Scott Benner 9:32
So you can shoot I know this is I know at this point, you're thinking like, Why can't this guy get this straight, but I don't know why it doesn't roll right in my head. So, hyperthyroidism, hypothyroidism, you can have hypothyroidism without Hashimotos. But if you have Hashimotos, that's an autoimmune disease that causes hypothyroidism. However, there yes there. So yes, you however, you could have hypothyroidism without having Hashimotos. Similarly, you can Couldn't have hyperthyroidism without graves. But if you have graves, you're going to have hyperthyroidism.

Unknown Speaker 10:06
Yes. There. Yes.

Scott Benner 10:09
I think I talked myself through it finally, my God. Alright, I'm going to leave this part in because my confusion is has to be other people's confusion

Jennifer Smith, CDE 10:18
there people's confusion. Absolutely. Because somebody you know, I know family member for you wise have issues with their thyroid, but not everybody in your family with thyroid disorder has an autoimmune thyroid disorder. Correct. So these are just the two main potential hypo or hyper that comes because their auto immune system is creating the problem. There are many other reasons you could have an Under or overactive thyroid issue that is not from autoimmune derived like problem

Scott Benner 10:57
yeah, to speak about. Oh my gosh, hold on. I don't know what's wrong, Amelia.

Jennifer Smith, CDE 11:03
Some water. Maybe it's winter, you know, dry house, I

Scott Benner 11:06
need hot tea. That's what I'm gonna get next time. So using my family as an example. My wife has hypothyroidism so does Arden. Neither of them are auto immune. My son had a real crazy like bout of like, like, I don't know, like it was a tough year in COVID. stressful and all that stuff. And then he got Hashimotos. As I look back on it now, we know because he did trial that when he was like 12 that Cole doesn't have any markers for type one diabetes, but I bet you if he did, he would have got type one diabetes. When this thing happened in his life. It's possible, you know,

Jennifer Smith, CDE 11:46
it's possible, just the body with the way that his body would deal with whatever environmental factor came in that turned it on.

Scott Benner 11:53
Right. So So then my kids are auto immune. Sensitive, let's just call it which is not a real thing. But it but probably and Oh, that's interesting.

Jennifer Smith, CDE 12:06
So yeah, well, and the other interesting thing is that Arden's thyroid disorder is not she has no autoimmune she that she has no antibodies for thyroid, right? So if those antibodies as we've defined kind of before, if those aren't there, then the reason for per thyroid problem is from something else, something else is going on, that's creating the havoc within her thyroid, right? Because, again, antibody positive would be autoimmune related in terms of like Hashimotos. So I'm gonna that's very interesting for her because she has an autoimmune disorder already.

Scott Benner 12:51
I'm gonna guess. Inflammation. Like I know that's such a word that people just throw around. But I think people with autoimmune issues have inflammation in their bodies and things go wonky because of it. And that is going to be my guess you have to treat our guts better than we do. We're doing that right now. For Arden are this take? Yes. All kinds of stuff. So I enjoy everyday arguing with her about taking the supplements.

Jennifer Smith, CDE 13:14
I'm sure that you do if she's still taking I'm curious if she's still taking or maybe one of you was taking Berberine for sensitivity my

Scott Benner 13:24
son was but but it stopped when we figured out those they were throwing at it before they realized he had Hashimotos Gotcha. Yes, she's um, she's just taking a couple of different probiotics like very, like, Target and Target potent probiotics. Fish oil. She's, we've had she's getting a blood draw today, actually. And then after that her vitamin D supplementation is going to go from pill form to liquid drops. Yeah, and some other things. So hopefully I'll report on that later with some success. Oh, well, there there we go. Now we're done with Graves disease, for sure. We muddled through. Yes. Well, that's my confusion. But I again, you know, I think that's what these these conversations are for to try to talk through this stuff because I don't know. Anyway.

A huge thank you to one of today's sponsors, G voc glucagon, find out more about Chivo Kibo pen at G Vogue glucagon.com Ford slash juicebox you spell that GVOKEGL You see ag o n.com. Forward slash juicebox. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. And hey, if you like Jenny and you'd like to hire her, she works at Integrated diabetes. dot com