Stress plays a key role in the pathogenesis of autoimmune diseases such as Graves' disease, Hashimotos' thyroiditis, and type 1 diabetes. Unfortunately physicians ignore this important causative factor. Subsequently medical treatment remains superficial and often unsatisfactory. In the case of Graves' disease, physicians rush to drugs, surgery and radioactive iodine, and create new troublesome medical conditions for the patient. In fact, autoimmune disease process continues and appear in various parts of the body with the passage of time.
As an endocrinologist, I see a lot of patients with autoimmune Type 1 diabetes and autoimmune thyroid diseases such as Over-active thyroid (Graves' disease) and Under-active thyroid (Hashimoto's thyroiditis). These patients often also have other autoimmune diseases such as celiac disease, rheumatoid arthritis, asthma, lupus, vitamin B12 deficiency. In these patients, I consistently find a high level of stress, usually a Type A personality (overachiever) and a lot of anxiety and fear. In addition, these patients are also low in Vitamin D.
I vividly remember one particular case: A young female came to see me for an over-active thyroid condition (Graves' disease). She was accompanied by her husband. During my first encounter, I found that her husband answered all of my questions. I didn't make much of it and thought that she was probably a shy person. I started her on a drug to treat Graves' disease.
A month later, on the second appointment, she was accompanied not only by her husband, but her five children. Her husband introduced each child, one by one. When he uttered their name, each child would stand up, step forward, say their name and sit down (only after being told to do so). Somehow, it reminded of the movie, "The Sound of Music" when the Von Trapp children introduce themselves with an almost Germanic military precision. Anyway, I thought this family was a bit odd, but didn't think much beyond that. I refilled the patient's medicine and advised her to see me again in two months with a repeat blood test. I did stress that the drug she was taking can cause serious side-effects, so close monitoring was advised.
Unfortunately, she did not show up for her next appointment. I got concerned and tried to contact her by telephone and letters, but to no avail. I kept thinking that without the medicine, she would develop severe symptoms of overactive thyroid and end up in the emergency department of a hospital.
Finally, one day she showed up in my office after about a year all by herself. During this visit, she couldn't stop talking. She was fluent in English and not shy at all.
She started by saying that her husband had passed away. "How do you feel?" I asked. "Oh! I'm feeling just fine. I haven't taken the medicine you prescribed for nine months, but I feel no symptoms of over-active thyroid." Then she also explained that her husband was extremely suspicious of her, kept her inside the house and was a control freak. She had been very afraid of him. She said her life was a "living hell on earth."
I went ahead and ordered a blood test to check her thyroid hormone level which, to my utter astonishment, turned out to be perfectly normal. To put things in perspective, Graves' disease usually requires a treatment with drugs for about two years or an ablation with radioactive iodine. It does not subside by itself in a matter of months. It is unheard of. And yet, that is what happened when the stress in her life disappeared. This case clearly illustrates the power of stress in causing Graves' disease, an autoimmune disorder.
In conclusion, stress management should be a crucial component in the overall treatment strategy of Graves' disease, Hashimoto's thyroiditis, type 1 diabetes and other autoimmune diseases.
No comments:
Post a Comment