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Hunger sensation in Graves' disease before and after pharmacological therapy
P Cugini1, A Paggi, G Cristina
1Institute of II Medical Clinic, University of Rome La Sapienza, Policlinico Umberto I, Italy. cugini@axrma.uniromal.it
Purpose:
Hunger sensation (HS) provides information about the need of eating in order to counterbalance the energy expenditure (EE). HS was, thus, investigated in patients affected by Graves' disease (PAGD), a clinical condition characterized by excessive EE.
Materials And Methods:
Ten newly diagnosed PAGD were investigated before and after therapy. Thirty clinically healthy subjects (CHS) were investigated as controls. The investigated subjects were asked to provide the 24-h profile of their HS by subjectively self-rating (from 1 to 10 hunger units) their orectic perception (OP) at regular intervals of 30 minutes (orexigram). The orexigrams were investigated via the conventional descriptive statistics as well as the Single-Cosinor method.
Results:
PAGD were found to show a very consistent increase of their HS (hyperorexia), whose day-night variability was, still, the expression of a circadian rhythm, characterized by an elevation in its oscillatory level and extent. Interestingly, the pre-treatment hyperorexia was seen to show a normalization (eurexia) after pharmacological therapy.
Conclusions:
According to these results, it can be affirmed that hyperorexia is a clinical sign of Graves' disease, which is obtained via mechanisms of tonic and amplitude modulation of the HS circadian rhythm. Because of the eurexia after remission, it can be argued that the hyperorexia is a theleological response really aimed at increasing food intake in order to counterbalance the excessive EE which characterizes the thyrotoxicosis.