# Graves' Rage



## davidhjkang

Hello! I am awaiting test results for Graves' disease and I think I have been experiencing episodes of "Graves Rage" and was wondering if this sounds about right.

Some days I will be feeling somewhat okay, then all of a sudden, if something irritates me even a little, it'll rapidly snowball into a rage full of hate and anger. Also, a big part of it is I will PHYSICALLY feel very stressed out. The physical urge to not clench my fists, or scream, or punch a wall and release it somehow is unbearable. After the episode, which varies how long, I will feel very fatigued (yet still stimulated, I think my adrenals are completely screwed up) and even sometimes end up taking a nap right after. When I do pass out, many times after this episodes in particular I will be awoken by sleep paralysis, which shows how fatigued my body actually was. When I wake up, I will feel very heavy, out of it, and weak. Also, a lot of the times after the initial rage part I will end up crying afterwords. Sometimes these rages are all chronic and I can't stand anyone all day.

Does this sound like Graves' Rage? Thanks so much.


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## webster2

Yes, it does.


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## Andros

davidhjkang said:


> Hello! I am awaiting test results for Graves' disease and I think I have been experiencing episodes of "Graves Rage" and was wondering if this sounds about right.
> 
> Some days I will be feeling somewhat okay, then all of a sudden, if something irritates me even a little, it'll rapidly snowball into a rage full of hate and anger. Also, a big part of it is I will PHYSICALLY feel very stressed out. The physical urge to not clench my fists, or scream, or punch a wall and release it somehow is unbearable. After the episode, which varies how long, I will feel very fatigued (yet still stimulated, I think my adrenals are completely screwed up) and even sometimes end up taking a nap right after. When I do pass out, many times after this episodes in particular I will be awoken by sleep paralysis, which shows how fatigued my body actually was. When I wake up, I will feel very heavy, out of it, and weak. Also, a lot of the times after the initial rage part I will end up crying afterwords. Sometimes these rages are all chronic and I can't stand anyone all day.
> 
> Does this sound like Graves' Rage? Thanks so much.


Yes it does; be careful you don't go into a thyroid storm.

Thyroid Storm Symptoms
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001437
http://www.emedicinehealth.com/thyroid_storm/page3_em.htm
http://thyroid.about.com/od/hyperthyroidismgraves/a/thyroidstorm.htm

Graves', neuropsychiatric

http://gravesdiseasetimbennie.com/ghdsection3of4part2.pdf
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1324966/

For more, just put Grave's Disease, Neuropsychiatric in your search engine.

This is a horrible horrible disease and it takes it's toll on the psyche big-time. I did counseling for 2 years in the aftermath.

God bless and take care.

I feel badly for you; you need to be on meds. When are you going to see the doctor about diagnosis and treatment?


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## webster2

If you haven't mentioned these episodes to your doctor, you need to ASAP.


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## davidhjkang

My dad's sending me on a plane to Korea soon because they have better thyroid treatment there (supposedly) because of how many Koreans have thyroid problems. I hope I will be okay on the flight...

I've learned to control the episodes but holding all that stress and adrenaline in has really screwed up my body and mind.

My heart rate hasn't been elevated and my levels have been (barely) within range. You guys think I'll be okay until then?

Unfortunately a doctor and endo here didn't take me very seriously.


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## davidhjkang

TSH .664 REF .550-4.780 
FT4 1.9 Range .8-1.8 
FT3 3.6 Range 2.3-4.2

Vitamin D Deficiency

TSI 58 0-139%

Ultrasound found no nodules or goiter.


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## talley

Could it be that there is something else going on other than with your thyroid? Is there a reason why you think your thyroid is the problem if testing shows normal ranges? Just makes me wonder if there is another problem that is not getting treated while the thyroid is being focused on...


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## davidhjkang

All the physical, mental, and cognitive symptoms seem to fit. Tension headaches, brain fog, alcohol intolerance, carpal tunnel, exercise intolerance, rage, and many many more all which are very closely related to thyroid conditions.

The two main things that are keeping me going are the fact that I did end up having TSI in my blood, although it's below range I'm not getting treated and if it's supposed to be under 20% before remission is considered that worries me especially when my symptoms are getting worse. Also I've been experiencing the eye symptoms as well. My eyes are sensitive to light, I feel the pressure of my eyeballs when I blink and pressure behind my eyes constantly, it's now strenuous to look left to right, and up to down, blurry vision (I've had 20/20 my whole life), and they are beginning to protrude which is proof enough for me.

Who knows.. whether it's a thyroid condition or not, I hope I get treatment soon :/.


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## Octavia

David, I'm curious...what country do you live in, since your dad is sending you to Korea for medical care? Do you feel confident you will be able to nagivate the medical system in a foreign country (if Korea is indeed a foreign country for you)?


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## davidhjkang

I'm born and raised in the San Francisco Bay Area but my parents are from Korea. I wouldn't feel confident at all especially in the (physical) state that I'm in, but I have relatives there that would be meeting me at the airport and guiding me. I think they have a hospital in mind already that focuses solely on the thyroid and any thyroid related illnesses.

I am hopeful because I think Korea has the highest percentage of thyroid diseases and thyroid cancer cases in the world so I would assume their healthcare when it comes to thyroid related illnesses is more comprehensive. I just hope I'm going to be okay on the flight. I feel like jumping out of my skin every second and the thought of sitting down for 12 hours is a little unnerving.


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## Andros

davidhjkang said:


> I'm born and raised in the San Francisco Bay Area but my parents are from Korea. I wouldn't feel confident at all especially in the (physical) state that I'm in, but I have relatives there that would be meeting me at the airport and guiding me. I think they have a hospital in mind already that focuses solely on the thyroid and any thyroid related illnesses.
> 
> I am hopeful because I think Korea has the highest percentage of thyroid diseases and thyroid cancer cases in the world so I would assume their healthcare when it comes to the Thyroid is more comprehensive. I just hope I'm going to be okay on the flight. I feel like jumping out of my skin every second and the thought of sitting down for 12 hours is a little unnerving.


That will be a long flight and I pray you will be alright on the flight also. You must let us know when you are going so we can all hold you in our thoughts and prayers.

But, if you want to get over this real quick, best thing to do is to have that thyroid removed. That will stop the attack.

Go over your choices carefully.


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## Andros

davidhjkang said:


> All the physical, mental, and cognitive symptoms seem to fit. Tension headaches, brain fog, alcohol intolerance, carpal tunnel, exercise intolerance, rage, and many many more all which are very closely related to thyroid conditions.
> 
> The two main things that are keeping me going are the fact that I did end up having TSI in my blood, although it's below range I'm not getting treated and if it's supposed to be under 20% before remission is considered that worries me especially when my symptoms are getting worse. Also I've been experiencing the eye symptoms as well. My eyes are sensitive to light, I feel the pressure of my eyeballs when I blink and pressure behind my eyes constantly, it's now strenuous to look left to right, and up to down, blurry vision (I've had 20/20 my whole life), and they are beginning to protrude which is proof enough for me.
> 
> Who knows.. whether it's a thyroid condition or not, I hope I get treatment soon :/.


You should not have any TSI; range or no range. This range is only to detect movement.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583

Substances not found in normal serum
http://www.thyroidmanager.org/Chapter6/Ch-6-6.htm


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## davidhjkang

Thanks so much Andros, the support is very much appreciated.

And I agree, I tried explaining to my endo that it wasn't a coincidence that I suspected Graves' Disease and I had TSI in my blood. He explained that if it was below range, then my symptoms were just anxiety. Anxiety.. unbelievable.


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## HotGrandma

David

Maybe some relaxing music or an audio book on head phones for the flight. Dark sun glasses to avoid eye contact. Close your eyes and relax. Concentrating (listening) to the head phones instead of everything else around you. Sort of a biofeedback ride. Also if there's a smell scent that makes you feel good take that with you too. Sometimes the smell of fresh oranges or a loved one's perfume has a calming effect. Most important close your eyes tight roll them up into your head and take long slow deep cleansing breaths until the rage feeling subsides. These help me. Good luck to you, dealing with this disease is a lonely dark place to be in.


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## Andros

davidhjkang said:


> Thanks so much Andros, the support is very much appreciated.
> 
> And I agree, I tried explaining to my endo that it wasn't a coincidence that I suspected Graves' Disease and I had TSI in my blood. He explained that if it was below range, then my symptoms were just anxiety. Anxiety.. unbelievable.


It is unbelievable but not to many of us on this board. It took 20 years for me to get diagnosed and only because I did in fact have thyroid storm and almost died.

This is in spite of the fact that I had a huge goiter, my eyes were totally popped out and a whole bunch of other obvious clinical symptoms.

Don't get me started. It took a lot of counseling for me to get over my anger re being so mistreated by the medical establishment. I was denigrated, fluffed off, told I was crazy etc..

That's why I am devoted to helping others now. Plus it's very healing for me to be doing this. Especially if I can help someone.


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## Octavia

davidhjkang said:


> I am hopeful because I think Korea has the highest percentage of thyroid diseases and thyroid cancer cases in the world so I would assume their healthcare when it comes to thyroid related illnesses is more comprehensive.


That's good, because sometimes, I don't think ours is all that impressive here in the U.S. Please let us know what you think when all is said and done.



davidhjkang said:


> I just hope I'm going to be okay on the flight. I feel like jumping out of my skin every second and the thought of sitting down for 12 hours is a little unnerving.


Can you ask your doctor for some anti-anxiety meds to take for the trip? I'd sure hate to see you on CNN because they had to land the plane elsewhere due to some passenger who was crawling out of his skin!


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## davidhjkang

Hey guys, I freaked out last night and went to the ER. My adrenals were really starting to freak me out. There was so much stress and adrenaline stored in my bloodstream from containing all the rage and stress in the last several months that my arms became so fatigued yet pumped with adrenaline I couldn't move them and they started shaking uncontrollably.

The doctor was wonderful and listened very thoroughly and I finally have an official diagnosis.

My question is, can adrenals induce thyroid storm or is that strictly TSH?

I'm pretty freaked out right now because the combination of extreme muscle weakness and over-stimulated of adrenaline at this point are creating some pretty intense bizarre muscle tremors, cramps, and spasms. Can this harm me?


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## davidhjkang

Sorry guys if that's a weird question I'm in a very delirious state of mind right now and freaking out.

And thanks so much for all the support.


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## Andros

HotGrandma said:


> David
> 
> Maybe some relaxing music or an audio book on head phones for the flight. Dark sun glasses to avoid eye contact. Close your eyes and relax. Concentrating (listening) to the head phones instead of everything else around you. Sort of a biofeedback ride. Also if there's a smell scent that makes you feel good take that with you too. Sometimes the smell of fresh oranges or a loved one's perfume has a calming effect. Most important close your eyes tight roll them up into your head and take long slow deep cleansing breaths until the rage feeling subsides. These help me. Good luck to you, dealing with this disease is a lonely dark place to be in.


What a lovely and caring post to our poster in need!! I like that.................a lot!


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## davidhjkang

HotGrandma said:


> David
> 
> Maybe some relaxing music or an audio book on head phones for the flight. Dark sun glasses to avoid eye contact. Close your eyes and relax. Concentrating (listening) to the head phones instead of everything else around you. Sort of a biofeedback ride. Also if there's a smell scent that makes you feel good take that with you too. Sometimes the smell of fresh oranges or a loved one's perfume has a calming effect. Most important close your eyes tight roll them up into your head and take long slow deep cleansing breaths until the rage feeling subsides. These help me. Good luck to you, dealing with this disease is a lonely dark place to be in.


Lonely and dark place only scratches the surface.. but thank you I shall try that on the flight. Will have to keep the sun glasses on the whole flight .


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## Octavia

david, what is your diagnosis, and how is it being treated?

(And I'm concerned about you flying...are you sure you can do it in your current state?)


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## webster2

Yes, I am concerned too. Did you receive a confirmation of Graves? Graves rages are really hard to control. Flying might pose a problem. Are you on medication?


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## davidhjkang

The ER doctor made the diagnosis based purely on my symptoms and slight eye protrusion. He spoke with me for 40 minutes and I explained everything to him from when I first started experiencing symptoms to present. He was wonderful. Although unfortunately I can't really call it an "official diagnosis" yet =/.

Guys, explaining this to my dad only made him even angrier at me. He screamed at me that I was in denial and that I somehow lied to the doctor to get him to believe me. As if doctors can easily be persuaded to make diagnosis' ESPECIALLY when it comes to thyroid conditions -_-. My parents didn't even wait with me at the ER. I sat there for 3 hours alone and had to take a cab back at 5 in the morning.

Anyways, he's pretty angry and told me to find a conclusive test online for Graves', and if it's negative he's kicking me out of the house. I'm not in a condition to be working or supporting myself and my mom (they're divorced) is also not supportive. They both believe I am being lazy and paranoid and I am making excuses not to deal with my life responsibilities. I'm just very ill... and need medical help. If I DO have Graves', then I shouldn't have anything to worry about I suppose.

The TSH-Recepter test is conclusive right? Does anyone know where I can find that test online?

I guess I don't have to worry about that flight now. Ugh how did my life become like this in less than a year. Please pray for me.


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## Megan1818

Sending you positive thoughts. It isn't a good feeling when you know something is going on with your health and not having a diagnosis or treatment. I can totally relate to you about not being taken seriously by some people. Keep advocating for yourself and don't give up!


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## webster2

I am really sorry for all that you are going through, especially with outsupport from your family. There are lab tests and physical characteristics ( I forget all 4). Someone with a better memory will let you know what they are.

I wish you the best.


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## Sandbar

davidhjkang said:


> The TSH-Recepter test is conclusive right? Does anyone know where I can find that test online?


TheTSI test you already got is conclusive - if you didn't have Graves it would have been zero. My own case was a little confusing for diagnosis but when the endocrinologist got the TSI result he said that settled it - it was just under the range cut off.

I've been following your story- feel so bad for you. I really hope you find the right medical help and that your family wakes up and starts supporting you. hugs2


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## davidhjkang

Thank you so much everyone. Truly.


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## Andros

Sandbar said:


> TheTSI test you already got is conclusive - if you didn't have Graves it would have been zero. My own case was a little confusing for diagnosis but when the endocrinologist got the TSI result he said that settled it - it was just under the range cut off.
> 
> I've been following your story- feel so bad for you. I really hope you find the right medical help and that your family wakes up and starts supporting you. hugs2


That is correct; thank you and...................................


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## Andros

davidhjkang said:


> The ER doctor made the diagnosis based purely on my symptoms and slight eye protrusion. He spoke with me for 40 minutes and I explained everything to him from when I first started experiencing symptoms to present. He was wonderful. Although unfortunately I can't really call it an "official diagnosis" yet =/.
> 
> Guys, explaining this to my dad only made him even angrier at me. He screamed at me that I was in denial and that I somehow lied to the doctor to get him to believe me. As if doctors can easily be persuaded to make diagnosis' ESPECIALLY when it comes to thyroid conditions -_-. My parents didn't even wait with me at the ER. I sat there for 3 hours alone and had to take a cab back at 5 in the morning.
> 
> Anyways, he's pretty angry and told me to find a conclusive test online for Graves', and if it's negative he's kicking me out of the house. I'm not in a condition to be working or supporting myself and my mom (they're divorced) is also not supportive. They both believe I am being lazy and paranoid and I am making excuses not to deal with my life responsibilities. I'm just very ill... and need medical help. If I DO have Graves', then I shouldn't have anything to worry about I suppose.
> 
> The TSH-Recepter test is conclusive right? Does anyone know where I can find that test online?
> 
> I guess I don't have to worry about that flight now. Ugh how did my life become like this in less than a year. Please pray for me.


I am praying for you. You need to have the doctor call your father and/or go to the Korean community for help w/this. A Korean doctor perhaps could intercede?


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## davidhjkang

Thanks Andros. My sister decided take me to her doctor tomorrow. I'm hoping to get a TSH-Receptor antibody and a cortisol saliva test issued. I'll let everyone know how that goes.

Should I bring my TSI result or leave it? I'm afraid if I bring it she might turn out to be one of the doctors who believe TSI must be way past "positive" range to be indicative of Graves' and she won't believe further testing is necessary. I wouldn't dare try to explain to her that it is indicative, because I've learned doctors absolutely hate that.


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## webster2

I wish you all the best, and hope you will get some treatment soon.


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## davidhjkang

Thanks webster. This is a great forum with many supportive, understanding people. Thank God for the internet. It makes me shudder to think how many people with thyroid conditions would suffer without the information that is readily available online to day. Man...


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## davidhjkang

Sandbar said:


> TheTSI test you already got is conclusive - if you didn't have Graves it would have been zero. My own case was a little confusing for diagnosis but when the endocrinologist got the TSI result he said that settled it - it was just under the range cut off.
> 
> I've been following your story- feel so bad for you. I really hope you find the right medical help and that your family wakes up and starts supporting you. hugs2


Thank you Sandbar, I hope so too. There really needs to be reformatting of the TSI test IMO.


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## webster2

davidhjkang said:


> Thanks webster. This is a great forum with many supportive, understanding people. Thank God for the internet. It makes me shudder to think how many people with thyroid conditions would suffer without the information that is readily available online to day. Man...


This is a great forum. I was at the end of my rope when I found this lovely community. The knowledge I learned here helped me so much in navigating my thyroid journey. I also learned to be an active partner in my care.

I really hope that you will get some help soon.


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## davidhjkang

Latest TSH .46 .49-4.67

I was also wondering if anyone had an idea why I am experiencing only certain symptoms of Graves'.

I don't suffer from:

-heat sensitivity
-weight loss/gain
-skin rashes
-racing heart (my heart rate has actually been quite normal)
-frequent bowel movements
-hair loss
-brittle nails
-many many immediately physical hyperthyroid symptoms

I do suffer from:

-brain fog
-rage
-extreme hyperactivity
-tremor
-fatigue
-difficulty thinking, concentrating
-exaggerated reflexes
-palpitations
-shortness of breath
-TED symptoms, including early eye proptosis 
-tension headaches
-and many more emotional, cognitive effects

I mean I still suffer from the physical aspect. Feeling extreme wired yet fatigued all day everyday. I've been an athlete my whole life as well. I just haven't been experiencing the symptoms a doctor would normal make his/her diagnosis on. At one point I have, but it was for a few months and went away.

My TSH is only miildly suppressed, although it's definitely going down. A month ago it was 1.29. Could it be that I've been experiencing just the autoimmune component of Graves' so far? And if I am, would anti-thyroid drugs or RAI even help at this point? Even with a diagnoses would I just have to wait until my TSH levels drop?


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## Lovlkn

> TSH .664 REF .550-4.780
> FT4 1.9 Range .8-1.8
> FT3 3.6 Range 2.3-4.2
> 
> Vitamin D Deficiency
> 
> TSI 58 0-139%


David,

Your symptoms seem extreme for your current labs.

Do you have any lab history with ranges you could share?

Has anyone offered you anxiety pills? When my FT-4 is in high range I have anxiety and can relate to that for sure.

Since your TSH is low range/ FT-4 over high range, it really surprises me they have not offered you anti thyroid meds.


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## davidhjkang

I just recently started taking Lexapro for the anxiety and the rage. What's funny is since Graves' Rage is more of a physical rage, I can still feel it, but thank goodness the Lexapro has been keeping me emotionally grounded. I've been able to do some light exercise and slowly alleviate the stress from my body without losing my mind. I really don't like being on antidepressants, but it's been really helpful given the situation.

I don't have much of a lab history, unfortunately I've only been educated about all this thyroid lab testing as of recently. I first experienced symptoms about 8 months ago but I thought it was just stress and anxiety. I've completely eliminated my anxiety in the past through cognitive behavioral therapy, and I understand anxiety conditions inside in out, so months later with no improvement I thought I didn't understand why my "anxiety wasn't getting better and thought I was just going insane.

I do have this from way back in June: TSH 0.76 0.40-4.50 mIU/L

This from yesterday: TSH 0.46 0.49-4.67

I haven't done a good job at all getting my FT's tested. At least my TSH shows consistency. What is the optimal level of TSH?


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## davidhjkang

Guys what are the chances I will go into psychosis? I'm really scared. The psychomotor agitation even with the lexapro has been incomprehensible. Beyond incomprehensible. I'm afraid I'm going to lose control of myself. The chances are what.. less than 1%?


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## Sandbar

Thank you Andros for the beautiful welcome birds!


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## Sandbar

David, could you describe what you are experiencing as psychomotor agitation? From what I understand psychosis is mainly a risk with a big sudden shift of thyroid levels or if one has extremely high levels. You should be okay. That said you are taking Lexapro, an SSRI, and it can potentially have a host of side effects. Akathisia is one to be wary of but is extremely rare.


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## davidhjkang

Ah. That makes me feel a ton better. I was talking about psychomotor agitation as in the physical nervous energy that I need to punch a wall or release the energy somehow from the Graves' rage is getting incomprehensible. I was afraid there was some link with rage and psychosis. I never like being out of control so instead of letting my emotions take over I usually try to sit still and wait it out. It's pure mind torture.

Anyways thanks for the info Sandbar. Goodness this disease is causing hypochondria like no other.


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## davidhjkang

Ah. After doing some research. Cortisol. The "stress" hormone. I've mixed this up with adrenaline as they both are apart of the flight or fight response. My hypothesis is that high cortisol levels from hyperthyroidism caused by Graves' is the culprit of Graves' rage. Adrenaline doesn't cause episodes of rage, although it can cause aggression. Cortisol causes that feeling of needing to release the energy from your body by punching something. Beginning to make sense now..


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