Effect of Single Dose Dexamethasone on the Concentration of Serum Triiodothyronine in Man

Duick, Daniel S.; Warren, Dwight W.; Nicoloff, John T.; Otis, Carol L.; Croxson, Michael

doi:10.1210/jcem-39-6-1151

Cited by 107 publications

(38 citation statements)

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“…These transient abnormalities in glucocorticoid deficient patients have been noted previously [14][15][16][17], and Topliss recommended that thyroid status should be reassessed after replacement [7]. In our case, high levels of thyroglobulin on admission decreased along with serum TSH after hydrocortisone replacement, and free T3 and free T4 increased inversely (Fig.…”

Section: Discussionsupporting

confidence: 76%

“…This may be due to the relative amelioration of glucocorticoid deficiency by relieving acute stress mainly caused by infection, as observed previously by Dexter [18]. Although pharmacological doses of glucocorticoids have been reported to depress serum T3 in man [17,19] and to inhibit iodide uptake into FRTL-5 rat thyroid cells [9], this case as well as cases in the literature may indicate that a physiological dose of glucocorticoid is needed for the synthesis or secretion of thyroid hormone under stimulation by TSH. Furthermore, none of the patients with a normal pituitary-thyroid axis was reported as possessing antithyroid antibodies, whereas cases with pituitary-thyroid abnormality had a high incidence of these antibodies (Table 2).…”

Section: Discussionmentioning

confidence: 60%

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Thyroid Dysfunction in isolated Adrenocorticotropic Hormone (ACTH) Deficiency: Case Report and Literature Review.

et al. 1993

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Abstract. A case of isolated ACTH deficiency accompanying transient primary hypothyroidism was reported along with a review of literature on isolated ACTH deficiency in Japan with special reference to its association with thyroid function. Our case, a 56-year-old woman, developed somnolence and hypoglycemia due to isolated ACTH deficiency. She also had the features of hypothyroidism, namely mounding phenomenon, muscle rigidity, increased plasma myogenic enzymes and cold intolerance. Both free T3 and free T4 were decreased, and basal as well as TRH-stimulated TSH levels were abnormally high. Plasma thyroglobulin was increased and no anti-thyroid antibodies were detected. All thyroid related physical and biochemical abnormalities disappeared after hydrocortisone replacement. A review of the literature on 103 cases disclosed that more than half the cases with isolated ACTH deficiency had a high plasma level of TSH, basal and/or TRH-induced, while the antithyroid antibodies were reported to be positive in only 13 cases. In more than 70% of such cases, the abnormality in the pituitary-thyroid axis was transient and was reversed by glucocorticoid replacement. Our case and cases in the literature indicate that the interference of thyroid hormone synthesis and/or secretion by glucocorticoid deficiency per se is the major cause of thyroid dysfunction rather than associated autoimmune thyroid disease.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 60%

Thyroid Dysfunction in isolated Adrenocorticotropic Hormone (ACTH) Deficiency: Case Report and Literature Review.

et al. 1993

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“…Coexisting GHD might decrease serum FT 3 levels because of decreased deiodinase acivity (20,21). Furthermore, it is well known that high-dose glucocorticoid replacement therapy inhibits deiodinase activity (12,13). However, there were few patients who had received such high-dose glucocorticoid treatment in our study and we did not find any differences in serum thyroid hormone levels between CeH patients with and those without ACTH deficiency.…”

Section: Discussioncontrasting

confidence: 53%

“…GH replacement therapy promotes peripheral T 4 to T 3 conversion (10,11), whereas high-dose glucocorticoid replacement therapy inhibits deiodinase activity (12,13), indicating that the status of replacement therapy is also important in determining the FT 3 /FT 4 ratio. Recently, it has been reported that serum FT 3 levels to FT 4 levels ratio (FT 3 /FT 4 ratio) is lower in patients with CeH than in control subjects (C) (14).…”

mentioning

confidence: 99%

Median-lower normal levels of serum thyroxine are associated with low triiodothyronine levels and body temperature in patients with central hypothyroidism

Hirata

Fukuoka

Iguchi

et al. 2015

European Journal of Endocrinology

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Objective: Although it has been recommended that serum free thyroxine (FT 4 ) levels should be targeted to middle-upper normal levels during levothyroxine (L-T 4 ) replacement therapy in patients with central hypothyroidism (CeH), the rationale has not been clarified. Methods: A retrospective single-center study enrolled 116 patients with hypothyroidism (CeH, nZ32; total thyroidectomy (Tx), nZ22; primary hypothyroidism (PH), nZ33; and control benign thyroid nodule (C), nZ29). The patients had received L-T 4 therapy at the Kobe University Hospital between 2003 and 2013. They were stratified according to serum FT 4 level (R1.10 or !1.10 ng/dl), and body temperature (BT), serum free triiodothyronine (FT 3 ) levels, FT 3 /FT 4 ratio, and lipid profiles were compared. The effect of GH replacement therapy on thyroid function was also analyzed. Results: FT 3 levels and FT 3 /FT 4 ratios were significantly lower in patients with CeH than in patients with PH (P!0.05) or C (P!0.05). In patients with FT 4 !1.10 ng/dl, BT was significantly lower in patients with CeH (PZ0.002) and Tx (PZ0.005) than in patients with PH, whereas no differences were found in patients with FT 4 R1.10 ng/dl. In patients with CeH, FT 3 levels were higher in those with GH replacement therapy (PZ0.018). Conclusion: In CeH, patients with median-lower normal levels of serum FT 4 exhibited lower serum FT 3 levels and lower BT. These results support the target levels of serum FT 4 as middle-upper normal levels during L-T 4 replacement therapy in patients with CeH.

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“…This production is dependent on liver glucose and glycogen [33] and enhanced through an insulinsuppressive action on paraventricular neuropeptide y secretion [34]. Additionally, hypoglycemia-induced glucocorticoids oppose T3 production [35]. Clinically, a calorie restricted, low carb diet causes a similar depression of T3 as starvation, which is not seen in calorie restricted carbohydrate feeding [36].…”

Section: Thyroid Hormonementioning

confidence: 99%

The Dangers of Fat Metabolism and PUFA: Why You Don’t Want to be a Fat Burner

Mamounis¹

2017

jevohealth

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Effect of Single Dose Dexamethasone on the Concentration of Serum Triiodothyronine in Man

Cited by 107 publications

References 0 publications

Thyroid Dysfunction in isolated Adrenocorticotropic Hormone (ACTH) Deficiency: Case Report and Literature Review.

Thyroid Dysfunction in isolated Adrenocorticotropic Hormone (ACTH) Deficiency: Case Report and Literature Review.

Median-lower normal levels of serum thyroxine are associated with low triiodothyronine levels and body temperature in patients with central hypothyroidism

The Dangers of Fat Metabolism and PUFA: Why You Don’t Want to be a Fat Burner

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