Graves' disease is the most common cause of hyperthyroidism. It is an autoimmune disease. The body produces stimulating antibodies against the thyroid-stimulating hormone (TSH) receptors on the thyroid gland. This results in stimulation of the thyroid to produce excessive amounts of the two thyroid hormones, triiodothyroniine (T3) and thyroxine (T4). The thyroid is no longer under the normal feedback control of pituitary TSH. Increased levels of T3 and T4 circulate in the bloodstream and affect the function of most organ systems in the body. The active hormone at the level of the cell nucleus is T3. Although both hormones are secreted by the thyroid, much of the secreted T4 is converted to T3 in peripheral tissues.
The effect of the excessive levels of thyroid hormones at the cellular level results in clinical symptoms experienced by the patient. The patient commonly notes palpitations, heat intolerance, sweating, shakiness, muscle weakness, nervousness, irritability, hair loss, and fatigue resulting from the revved up metabolism. These symptoms are nonspecific and may suggest an etiology other than thyroid disease to both patient and physician. Thus, the patient may wait weeks or months before seeking medical help. Then the physician may diagnose stress or panic disorder and prescribe a tranquilizer. Again, weeks or months may go by before the physician thinks about hyperthyroidism. Once the doctor considers the possibility of hyperthyroidism, it is relatively easy to verify the diagnosis with a TSH test. The following case discussions illustrate a variety of clinical presentations, physical findings, and an approach to differential diagnosis and treatment.
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It seems like you hear it all the time from nearly every one you know I'm SO stressed out!? Pressures abound in this world today. Those pressures cause stress and anxiety, and often we are ill-equipped to deal with those stressors that trigger anxiety and other feelings that can make us sick. Literally, sick.