The Influence of Total Starvation on the Pituitary-Thyroid-Axis in Obese Individuals

Rothenbuchner, G; Loos, U.; Wr, Kiessling; Birk, J.; Ef, Pfeiffer

doi:10.1530/acta.0.072s144

Cited by 21 publications

(10 citation statements)

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“…While these studies were in progress, an abstract by Rotheribuchner and co-workers reported that serum T3 in obese subjects declined moderately during 4 weeks of fasting. In contrast to the present findings, however, decreases in basal serum T4 and TSH concentrations, as well as a delayed TSH response and a decreased T3 response to TRH, were noted (11). pheral conversion of T4 to T3 explains the decrease in serum T3 concentration that starvation induces.…”

Section: Discussioncontrasting

confidence: 99%

The Effect of Starvation on the Concentration and Binding of Thyroxine and Triiodothyronine in Serum and on the Response to TRH

Portnay

O’Brian

Bush

et al. 1974

The Journal of Clinical Endocrinology & Metabolism

242

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In 9 euthyroid obese volunteers, 4 weeks of total caloric deprivation resulted in striking decreases in both total and free triiodothyronine (T3) concentrations in serum together with a slight increase in free thyroxine (T4) concentration. These changes were not associated with alterations in the basal serum TSH concentration or in the TSH or T3 responses to exogenous TRH. It is suggested that the decrease in serum T3 concentration that occurs during starvation results from decreased peripheral conversion of T4 to T3 and may explain, at least partially, the decreased serum T3 seen in clinical states associated with inanition.

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Section: Discussioncontrasting

confidence: 99%

The Effect of Starvation on the Concentration and Binding of Thyroxine and Triiodothyronine in Serum and on the Response to TRH

Portnay

O’Brian

Bush

et al. 1974

The Journal of Clinical Endocrinology & Metabolism

242

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“…In 1973, Rothenbuchner et al reported decreased serum concentrations of T3 in the starving organism (47). Nearly simultaneously another group confirmed this observation in a different population (49).…”

Section: Historical Overviewmentioning

confidence: 99%

“…Early reports that serum concentrations of T3 are reduced in states of low caloric intake (47, 49) gave rise to the concept of what we now call the Low-T3 syndrome. Reduced T3 concentrations have been described in various conditions associated with energy deprivation, including anorexia nervosa (183–185), calorie-free diet in obesity (47), military combat training with caloric restrictions (186, 187) and other energy-deficient situations (188).…”

Section: Thyroid Allostasis In Various Physiological and Pathologicalmentioning

confidence: 99%

“…Reduced T3 concentrations have been described in various conditions associated with energy deprivation, including anorexia nervosa (183–185), calorie-free diet in obesity (47), military combat training with caloric restrictions (186, 187) and other energy-deficient situations (188). Even moderate weight loss may result in hypodeiodination with consecutive decreased T3 concentrations (189).…”

Section: Thyroid Allostasis In Various Physiological and Pathologicalmentioning

confidence: 99%

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Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming

Hoermann²,

et al. 2017

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The hypothalamus–pituitary–thyroid feedback control is a dynamic, adaptive system. In situations of illness and deprivation of energy representing type 1 allostasis, the stress response operates to alter both its set point and peripheral transfer parameters. In contrast, type 2 allostatic load, typically effective in psychosocial stress, pregnancy, metabolic syndrome, and adaptation to cold, produces a nearly opposite phenotype of predictive plasticity. The non-thyroidal illness syndrome (NTIS) or thyroid allostasis in critical illness, tumors, uremia, and starvation (TACITUS), commonly observed in hospitalized patients, displays a historically well-studied pattern of allostatic thyroid response. This is characterized by decreased total and free thyroid hormone concentrations and varying levels of thyroid-stimulating hormone (TSH) ranging from decreased (in severe cases) to normal or even elevated (mainly in the recovery phase) TSH concentrations. An acute versus chronic stage (wasting syndrome) of TACITUS can be discerned. The two types differ in molecular mechanisms and prognosis. The acute adaptation of thyroid hormone metabolism to critical illness may prove beneficial to the organism, whereas the far more complex molecular alterations associated with chronic illness frequently lead to allostatic overload. The latter is associated with poor outcome, independently of the underlying disease. Adaptive responses of thyroid homeostasis extend to alterations in thyroid hormone concentrations during fetal life, periods of weight gain or loss, thermoregulation, physical exercise, and psychiatric diseases. The various forms of thyroid allostasis pose serious problems in differential diagnosis of thyroid disease. This review article provides an overview of physiological mechanisms as well as major diagnostic and therapeutic implications of thyroid allostasis under a variety of developmental and straining conditions.

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“…It is well recognized that starvation and malnutrition are associated with changes in thyroid hormone economy in man, characterized by a decrease in outer-ring deiodi-thyroid hormones [2][3][4], Studies so far have been carried out either in iodine-deficient areas [5,6] or in countries where the population receives sufficient iodine [2][3][4]7], The influence of iodine intake on the peripheral metabo lism of the thyroid hormone and on pituitary-thyroid function during dietary manipulation has only been eval uated using large amounts of iodine [8,9].…”

Section: Introductionmentioning

confidence: 99%

Effect of Small Doses of Iodine on Thyroid Function during Caloric Restriction in Normal Subjects

Reinhardt¹,

Holtermann²,

Benker³

et al. 1993

Horm Res

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It is well recognized that starvation and malnutrition are associated with a low-T3 syndrome in man. A similar condition has been observed after intake of a low carbohydrate hypocaloric diet. However, little is known about the influence of iodine on these conditions. Therefore, we evaluated the effect of iodine supplementation on thyroid function before and after a short-term intake of a low carbohydrate diet in normal subjects residing in an iodine-deficient area. The study was performed in 16 young euthyroid, nonobese volunteers (11 males, 5 females). The subjects were placed on a low carbohydrate (800 kcal) diet for 4 days. Eight subjects received 500 µg iodine (oral) daily beginning 4 weeks before diet. The control group (n = 8) received no iodine. After iodine supplementation, iodine excretion increased from 52 to 405 µg iodine/g of creatinine. Total T4 showed a slight but significant increase (104.2 nmol/lvs. 115.8 µg/dl;p < 0.001);fT₄ was unchanged. The intake of the hypocaloric low carbohydrate diet resulted in a striking decrease in both total and free T₃ and an increase of rT₃ irrespective of iodine supplementation. T₄and fT4 were not affected in either group. During diet, iodine administration resulted in a decrease of basal TSH from 2.3 to 1.2 mU/1 (p < 0.05), ΔTSH from 10.3 to 4.5 mU/1 (p < 0.01) and ΔT₃ (T₃ 180 min after TRH) from 0.7 to 0.3 nmol/l (p < 0.01). In contrast, no significant changes of basal TSH and T₃response after TRH were seen during diet in the control group. In conclusion, changes of T₃, rT₃ and rT₃ during caloric restriction occurred irrespective of iodine supplementation. However, significant alterations in basal TSH and T₃ response after TRH could only be demonstrated in subjects receiving iodine supplementation.

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The Influence of Total Starvation on the Pituitary-Thyroid-Axis in Obese Individuals

Cited by 21 publications

References 0 publications

The Effect of Starvation on the Concentration and Binding of Thyroxine and Triiodothyronine in Serum and on the Response to TRH

The Effect of Starvation on the Concentration and Binding of Thyroxine and Triiodothyronine in Serum and on the Response to TRH

Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming

Effect of Small Doses of Iodine on Thyroid Function during Caloric Restriction in Normal Subjects

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