Treatment of Psychoses in Early Childhood With Triiodothyronine

Sherwin, Albert C.; Flach, Frederic F.; Stokes, Peter E.

doi:10.1176/ajp.115.2.166

Cited by 24 publications

(8 citation statements)

References 2 publications

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“…Several preliminary clinical studies that have suggested a favourable response to thyroid hormone supplementation in children with ASD and animal models have demonstrated an improvement in ASD behaviours with T4 supplementation . Although thyroid hormone supplementation would appear to be counter to our behavioural data and the fact that TT3 and rT3 was found to be above normal in a high percentage of children with ASD, it is possible that such supplementation could reduce variations in the HPA, leading to a more stable regulation of thyroid hormones.…”

Section: Discussioncontrasting

confidence: 63%

“…There is increasing recognition that thyroid dysfunction is associated with neurological and psychiatric disease, including neurodevelopmental disorders such as intellectual disability and autism spectrum disorder (ASD), focal and generalised neurological abnormalities, as well as psychiatric manifestations such as psychosis, panic attacks, anxiety disorders, bipolar disorder, depression and schizophrenia . In addition, normal thyroid function is essential for normal cognition .…”

Section: Introductionmentioning

confidence: 99%

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Thyroid dysfunction in children with autism spectrum disorder is associated with folate receptor α autoimmune disorder

Frye

Wynne

Rose

et al. 2017

J Neuroendocrinology

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Folate receptor α (FRα) autoantibodies (FRAAs) are prevalent in autism spectrum disorder (ASD). FRAAs disrupt folate transport across the blood-brain barrier by binding to the FRα. Thyroid dysfunction is frequently found in children with ASD. We measured blocking and binding FRAAs and thyroid-stimulating hormone (TSH), free thyroxine (T4) (FT4), total triiodothyronine (T3) (TT3), reverse T3 (rT3), thyroid-releasing hormone (TRH) and other metabolites in 87 children with ASD, 84 of whom also underwent behaviour and cognition testing and in 42 of whom FRAAs, TSH and FT4 were measured at two time points. To better understand the significance of the FRα in relation to thyroid development, we examined FRα expression on prenatal and postnatal thyroid. TSH, TT3 and rT3 were above the normal range in 7%, 33% and 51% of the participants and TRH was below the normal range in 13% of the participants. FT4 was rarely outside the normal range. TSH concentration was positively and the FT4/TSH, TT3/TSH and rT3/TSH ratios were inversely related to blocking FRAA titres. On repeated measurements, changes in TSH and FT4/TSH ratio were found to correspond to changes in blocking FRAA titres. TSH and the FT4/TSH, TT3/TSH and rT3/TSH ratios were related to irritability on the Aberrant Behavior Checklist and several scales of the Social Responsiveness Scale (SRS), whereas TT3 was associated with SRS subscales and TRH was related to Vineland Adaptive Behavior Scale subscales. The thyroid showed significant FRα expression during the early prenatal period, although expression decreased significantly in later gestation and postnatal thyroid tissue. The results of the present study suggest that thyroid dysfunction in ASD may be related to blocking FRAA. The high expression of FRα in the early foetal thyroid suggests that foetal and neonatal exposure to maternal FRAAs could affect the development of the thyroid and may contribute to the pathology in ASD.

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Section: Discussioncontrasting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Thyroid dysfunction in children with autism spectrum disorder is associated with folate receptor α autoimmune disorder

Frye

Wynne

Rose

et al. 2017

J Neuroendocrinology

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“…Our finding of lower TSH values in autistic children suggests that they may have hypothyroidism. This is supported by the early literature (Sherwin et al 1958, Khan 1970). However, it has been reported that levels of triiodothyronine (T3), thyroxine and TSH in autism were within the normal range, and that T3 was not therapeutically effective (Abassi et al 1978, Campbell et al 19876).…”

Section: Discussionsupporting

confidence: 67%

Reduced Thyroid‐Stimulating Hormone Response to Thyrotropin‐Releasing Hormone in Autistic Boys

Hashimoto

Aihara

Tayama

et al. 1991

Develop Med Child Neuro

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SUMMARY RÉSUMÉ Réduction de la TSH par rapport à la TRH chez les garçons autistiques La thyréostimuline (TSH) et la réponse de prolactine à la thyréolibérine (TRH) ont été comparées chez des garçons parmi lesquels il y avait 41 autistiques, 12 retardés mentaux (RM) et 12 présentant un dysfonctionnement cérébral a minima (MBD). Les garçons autistiques ont été divises en deux groupes: Q.D. ou Q.I. >ou =à 80, et Q.D. ou Q.I. <80. Les taux moyens de base et de pointe de la TSH étaient significativement plus bas dans les deux groupes autistiques que parmi les groupes RM, MBD et contrǒles. L'écart (p‐b) entre la valeur moyenne de pointe et la valeur moyenne de base de la TSH était significativement plus bas dans les deux groupes autistiques que chez les contrǒles. Les taux moyens et les valeurs p‐b pour la prolactine ne différaient pas entre les groupes. Les auteurs suggèrent qu'il peut y avoir une activité dopaminergique renforcée et/ou une activité sérotoninergique réduite dans le système nerveux central des enfants autistiques, à cǒté d'un dysfonctionnement hypothalamique. ZUSAMMENFASSUNG Verminderte TSH Stimulierbarkeit durch TRH bei autischen Kindern Bei 41 Jungen mit Autismus, 12 mit geistiger Retardierung (MR) und 12 mit minimaler Hirnfunktionsstörung (MBD) wurden das Thyreoidea‐stimulierende‐Hormon (TSH) und die Prolaktinreaktion auf Thyreotropin‐releasing‐Hormon (TRH) verglichen. Die autistischen Jungen wurden in zwei Gruppen eingeteilt: DQ(1Q) ≥80 und DQ(1Q) <80. Die mittleren Basalwerte und die maximal stimulierbaren Werte für TSH waren in beiden autistischen Gruppen signifikant niedriger als bei der MR‐, der MBD‐ und der Kontrollgruppe. Der mittlere maximal stimulierbare TSH Wert minus Basalwert (p‐b) war bei beiden autistischen Gruppen niedriger als bei der Kontrollgruppe. Zwischen den Gruppen fand sich kein Unterschied für die mittleren Prolaktinspiegel und den p‐b Wert. Man nimmt an, daß es im Zentralnervensystem autistischer Kinder eine erhölte dopaminerge und/oder eine verminderte serotinerge Aktivität in Verbindung mit einer hypothalamischen Dysfunktion gibt. RESUMEN Reduccion de TSR frente a TRH en muchachos autisticos Se compararon las respuestas de la hormona tiroido‐estimulante (TSH) y de la prolactina a la hormona liberadora de la tirotropina (TRH) en 41 muchachos autistas, 12 retrasados mentales (RM) y 12 con disfunción cerebral minima (DCM). Los autistas se dividieron en dos grupos: CD(C1) ≥80 y CD(CI) <80. Los niveles promedio de la TSH basal y su pico eran significativamente más bajos en ambos grupos autísticos que en las grupos RM DCM y control. El valor promedio del pico de TSH, menos el valor basal (p‐b) era significativamente más bajo en ambos grupos autísticos que en el grupo control. Los niveles promedio de prolactina y el valor p‐b no diferian entre los grupos. Se sugiere que debe haber una facilitación dopaminérgica y/o una reducción de la actividad serotoninérgica en el sistema nervioso central de los niños autisticos, junto con una disfun...

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“…Nonetheless, currently there is a dearth of information on the potential role of thyroid disorders in autism. In 1958, triiodothyronine was first used for the treatment of autism with some improvement [115], leading to the finding in Britain of low thyroid values in 45 of 62 autistic children [116]; however, controlled trials failed to confirm positive results of this therapy [117][118][119]. Naturally, the developmental brain changes caused by in utero hypothyroidism are permanent and should not improve with postnatal thyroid hormone treatment.…”

Section: Existing Evidencementioning

confidence: 99%

Autism: Transient in utero hypothyroxinemia related to maternal flavonoid ingestion during pregnancy and to other environmental antithyroid agents

Román

2007

Journal of the Neurological Sciences

135

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Treatment of Psychoses in Early Childhood With Triiodothyronine

Cited by 24 publications

References 2 publications

Thyroid dysfunction in children with autism spectrum disorder is associated with folate receptor α autoimmune disorder

Thyroid dysfunction in children with autism spectrum disorder is associated with folate receptor α autoimmune disorder

Reduced Thyroid‐Stimulating Hormone Response to Thyrotropin‐Releasing Hormone in Autistic Boys

Autism: Transient in utero hypothyroxinemia related to maternal flavonoid ingestion during pregnancy and to other environmental antithyroid agents

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