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Abstaining Opioid Drugs as a Possible Risk Factor for Graves’ Disease

Shahin Banaei Boroujeni , Azam Ghanei, Golnaz Malekzadeh, Mehdi Mirzaei-Alvijeh and Ehsan Zarepur

Introduction: Graves’ disease is an autoimmune disease with obscure etiology. It may be associated with an underlying emotional stress of any kind. On the other hand abstaining opioid drugs’ addiction is a major stress that can develop this disease. Confronting several patients who were attacked by Graves’ disease, with the history of opioid abstinence led us to investigate them more and report the findings. Methods: In this case series study 46 patients who were addicted to opioid drugs and have abandoned it less than 9 months from the admission time to endocrinologist were investigated. They all presented the signs and symptoms of Graves’ disease. Thyroid function tests consist of T3, T4 and TSH were measured for each patient and compared against the ones before opioid abstinence. Statistical analysis was performed by using T- Test and SPSS 18.0 software. Results: 46 patients, which include 2 women and 44 men were studied. The lab results before opioid abstinence confirmed that all were euthyriod. The serum level of T3 increased from 126.3026 ± 34.2356 ng/dl to 311.3696 ± 79.80932 ng/dl after opioid abstinence, this level for T4 also increased from 8.1130 ± 1.54684 ng/dl to 18.4674 ± 3.5589 ng/dl. The difference between thyroid hormone before and after opioid abstinence was statistically significant (P<0.05). The serum level of TSH decreased from 1.3457 ± 0.68043 ng/dl to 0.0289 ± 0.0294 ng/dl which was also statistically significant (P<0.05). Conclusion: Opioid drugs’ abstinence may develop Graves’ disease. More investigation is suggested.