Getting thyroid gland under control when Graves' disease puts it in overdrive

PLYMOUTH MEETING, Pa. (WPVI) -- The thyroid gland affects nearly every organ in the body, usually working silently.

When it becomes under- or over-active, it can upend life. In Graves' disease, the thyroid goes haywire.

"I had no real symptoms," recalls Nica Bellenger.

So Bellenger was surprised when a routine physical 10 years ago showed high levels of thyroid hormones.

Medication kept it in check till last year when symptoms roared in: insomnia, high heart rate and high blood pressure.

"My body was on overdrive, saying you gotta go, go, go, go, go," Nica says, of the hyper feeling she experienced.

Graves' disease is an autoimmune disease in which the immune system attacks the thyroid, causing hormones to surge.

"We were concerned that I would go into cardiac arrest at some point, because of my high heart rate," she notes.

Antibodies can also attack tissue around the eye.

"It kind of pushes the eyes forward, and some patients get this bulging look to their eyes," says Dr. Lindsay Kuo, a Temple Health endocrine surgeon.

It can run in families, but there's no consistent thread of how it runs.

Bellenger's specialist sent her to Dr. Kuo, who says there are two primary treatments for severe Graves' disease: Taking radioactive iodine to destroy the thyroid, or surgery to remove the thyroid.

Bellenger says it was a difficult decision, with many considerations.

With the iodine a patient is radioactive.

"You really can't necessarily be around small children right away," says Dr. Kuo.

That posed a challenge for Nica, "And I have two elementary kids."

On the other hand, surgery had challenges for Nica, too.

Surgery requires a high level of expertise because the very inflamed thyroid gland, plus its location close to lymph nodes and vocal cords raises the complication risks.

"This takes anywhere from two to four hours depending on how large the thyroid gland is. It is usually done are typically done through an incision at the base of the neck. And the incision size really depends on the size of the thyroid," says Dr. Kuo.

So a doctor's experience is important.

"Surgeons who focus on the thyroid are known to have fewer complications afterward," says Dr. Kuo.

In the end, Nica chose surgery, in large part because of Dr. Kuo's experience and thoroughness in explaining the options.

"She seemed like the perfect fit because she does this type of surgery often, a couple times a week," says Nica.

"Day in and day out, she does this surgery, she's come across many different situations," she adds.

Nica had surgery early in 2023, and went home the same day.

There was initially a lot of swelling around the surgery site, due to sensitive tissues there. But a week later, she was back at work and doing most of her regular activities.

"Wawa ice cream was my go-to," for soothing the discomfort, says Nica.

Six weeks later, she was grateful to Dr. Kuo for putting her at ease from start to finish.

"You can kind of see my scar here. It's very, very light, it's already starting to fade away," she says, showing her scar.

And Dr. Kuo says that hyper feeling fades.

"Once the thyroid gets under control, you should have a lot, you should feel a lot better," she says.

With either treatment, people will need daily thyroid replacement pills. But once they're on the right dose, most feel like their old selves. Doctors don't know what triggers Graves' disease.

It can run in families, but there's no consistent thread of how it runs in a family if it happens.