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Studies on dys function of hypothalamic pituitary thyroid axis part 1 studies on dys function of hypothalamic pituitary thyroid axis in chronic thyroiditis



Studies on dys function of hypothalamic pituitary thyroid axis part 1 studies on dys function of hypothalamic pituitary thyroid axis in chronic thyroiditis



Medical Journal of Kobe University 36(3): 1-8



In order to study the pituitary-thyroid axis and prolactin (PRL) secretion in chronic thyroiditis, plasma thyrotropin (TSH), triiodothyronine (T3) and PRL levels were measured before and after the i.v. administration of 500 .mu.g synthetic thyrotropin-releasing hormone (TRH) in 68 patients with chronic thyroiditis. As controls, 16 normal subjects of similar ages were also studied. In 48 patients with chronic thyroiditis, who had normal free thyroxine index (FTI) values (1.4-5.3), mean basal TSH level was 8.1 .+-. 1.9 .mu.U[units]/ml (Mean .+-. SE), which was significantly higher than that of normal controls (P < 0.05). The responses of TSH to 500 .mu.g TRH were exaggerated in most of those cases. Mean basal T3 was 133.3 .+-. 4.4 ng/dl, which was slightly, but insignificantly, higher than that of normal control, 126.4 .+-. 4.8 ng/dl. Plasma T3 was elevated after TRH injection, but in 16 of 29 patients with normal basal TSH and all of 12 patients with high basal TSH, plasma T3 rise was significantly blunted. Latent hypothyroidism probably is common among patients with chronic thyroiditis who have normal plasma thyroid hormone. All of 15 patients with low FTI (< 1.4) had the markedly raised TSH level exceeding 68 .mu.U/ml. Plasma TSH levels were further elevated after TRH injection reaching to 246.0 .+-. 60.7 .mu.U/ml at 60 min. Mean plasma T3 in those patients was 75.5 .+-. 4.0 ng/dl. This value was significantly lower than in normal controls (P < 0.01). TRH injection did not cause significant increase in plasma T3 in 13 of 15 patients studied. The elevated TSH apparently stimulates T3 secretion from the thyroid gland in patients with chronic thyroiditis, although no more reserve is left to respond further to elevated TSH. Mean basal PRL in 24 patients with chronic thyroiditis (normal FTI group) was 16.3 .+-. 2.8 ng/ml. However, TRH injection caused exaggerated response in 13 of 24 patients. In 7 patients with chronic thyroiditis (low FTI group), the mean basal PRL value was 56.7 .+-. 20.9 ng/ml. The response of plasma PRL to TRH were exaggerated, and mean PRL levels at 30 and 60 min after TRH injection were 124.3 .+-. 11.9 and 106.4 .+-. 21.8 ng/ml, respectively, which were significantly higher than in normal FTI group (P < 0.05). Subnormal plasma thyroid hormone levels may stimulate the secretion of PRL from the pituitary.

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Accession: 006506588

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