Q: My friend was just diagnosed with Graves’ disease, but I don’t know much about it. I want to be supportive and educate myself. What is Graves’ disease, and how does it affect the body? How is it treated?
A: Graves’ disease is an autoimmune disease that leads to an overactive thyroid. It is caused by antibodies attacking the thyroid by mistake. The thyroid and the hormones it produces are the gas pedal for the body. When someone produces too much thyroid hormone, the body goes into overdrive. Your pulse increases, you overheat, you lose sleep — these symptoms make people feel so unwell that they seek medical attention. This is what leads to additional testing and the diagnosis of Graves’ disease.
While the body is in overdrive, muscle strength is lost and the heart beats faster, adding extra wear and tear. Much like a car running at a high RPM (revolutions per minute) for an extended time, that’s not good for the engine. The goal is to treat this overactive phase when treating Graves’ disease.
The main complication of Graves’ disease is thyroid eye disease. Inflammation and bulging of the eyes occur in a third of people diagnosed with Graves’ disease. Managing thyroid eye disease requires an endocrinologist to address the thyroid and ophthalmologists who deal with eye changes. Ear, nose and throat specialists are occasionally involved in surgeries related to the eye disease as well.
Research and innovation surrounding Graves’ disease is ongoing. The ability to create molecules that hit a specific target has increased tremendously over the past few years. This is particularly effective when we know the mechanism of a disease and what the target should be.
With thyroid eye disease, we know the receptor we aim to block. A number of clinical trials aim to block that receptor, improve the eye disease and, for some of these drugs, treat the Graves’ disease at the same time.
Targeting some of these areas has resulted in noticeable improvement in eye disease in the past several years. Furthermore, there are molecules in development that, in the next few years, will likely show ability to prevent the eye disease or reverse some of these changes that have already occurred. They’ll do this by lowering, if not eliminating, the antibodies that are causing the problem in the first place. Some of the early results of Mayo Clinic trials in particular show major benefits for patients in the coming years.
Mayo Clinic Q&A is an educational resource and doesn’t replace medical care. Email a question to MayoClinicQ&A@mayo.edu.