Stressful life events and Graves' disease

The search of an explanation for the onset of any disease state is reflected in all cultures, and the idea that psychic distress may predispose to illness is centuries old. Recently, scientific evidence was provided for an interaction between the central nervous and the immune systems (1). Psychological stimuli may set off patterns of neurotransmitters, hormones and cytokines. which act on receptors within the immune system and alter immune function either directly or through induction of other substances (1, 2). As a consequence, during stressful life events, alterations in the neuroendocrine system may functionally affect the immune system. The cause of Graves’ disease is unknown, but there is compelling evidence that its pathogenesis is auto-immune. It is therefore possible that stress-related changes in immune function could precipitate the disease in individuals genetically predisposed to thyroid autoimmunity. Despite this theoretical chain of events and an array of early clinical evidence, the role of stress in the onset of Graves’ disease has remained controversial.