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TRH stimulation test in normal and in thyroid disorders

Journal of the Medical Association of Thailand 67(10): 553-561
TRH stimulation test in normal and in thyroid disorders
The normal and abnormal responses of TSH to synthetic TRH in 71 normal Thais and in 54 patients with thyroid disorders were defined. The concentrations of serum TSH were determined by double antibody RIA [radioimmunoassay] before and after giving 200 .mu.g of TRH at 20 and 60 min. The results revealed that normal individuals responded to TRH with reproducible increments in serum TSH. The means .+-. SE of TSH response to TRH in 71 euthyroid subjects were 1.5 .+-. 0.2 mIU/l at basal level, 13.0 .+-. 0.9 mIU/l at 20 min and 9.6 .+-. 0.7 mIU/ml at 60 min. The mean maximum increments in serum TSH at 20 min were found to be 12.0 .+-. 0.9 mIU/l with a range of 7-22 mIU/l. Sex and age differences were evaluated and the results indicated that the basal TSH levels in 48 normal females and in 23 males were not different. Hyperthyroid patients (31) showed a total lack of response to TRH and very low mean values of serum TSH at 0, 20 and 60 min were 0.5 .+-. 0.1, 0.5 .+-. 0.1 and 0.4 .+-. 0.04 mIU/l, respectively. In contrast to hyperthyroidism, all patients with primary hypothyroidism had markedly elevated baseline TSH levels. These findings suggest that the TSH response to TRH should be a sensitive and effective test in the diagnosis of thyroidal dysfunction and this test may have promise in replacing or complementing the tedious thyroid-suppression test. TRH stimulation can be used as a test of pituitary-hypothalamic function with regard to TSH.

Accession: 006839815

PMID: 6440942

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