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Thyrotropin secretion in thyrotoxic and thyroxine-treated patients: assessment by a sensitive immunoenzymometric assay.
J Clin Endocrinol Metab. 1986 Aug; 63(2):349-55.JC

Abstract

A new TSH immunoenzymometric assay was found to be capable of discriminating between the serum TSH values of normal subjects [2.28 +/- 1.02 (+/-SD); range, 0.6-6.5 microU/ml] and those of clinically euthyroid, antithyroid drug-treated (n = 22) or clinically thyrotoxic (n = 34) patients. While a wide spectrum of basal TSH values was found in the antithyroid drug group [ranging from undetectable (less than 0.05 microU/ml: 57%) to 17.9 microU/ml], all clinically thyrotoxic patients had undetectable values. In 33 patients receiving chronic oral T4 therapy for treatment of goiter (n = 15) or thyroid cancer (n = 18), 48% (6 of 33) had undetectable basal TSH levels and no TSH response to TRH stimulation. Detectable TSH levels were found in 42% (14 of 33), and TRH responsiveness was found in 52% (17 of 33). The TSH response to TRH stimulation was less than 2.0 microU/ml in 7 patients. Serum free T4 index, free T3 index, and free T4 levels and oral T4 dosage were inferior predictors of TRH responsiveness compared to the basal TSH value. No patient receiving more than 0.2 mg T4 daily or having a free T4 index above 18, a free T3 index above 205 or a free T4 level above 3.0 ng/dl had a TSH response to TRH. Seventy-six percent (16 of 21) of the patients, when reevaluated 1-6 weeks after increased oral T4 dosage, had a significant reduction in their serum thyroglobulin level. This was true of both patients with initially detectable (11 of 14) as well as undetectable (5 of 7) basal serum TSH levels. These findings support the concept that subnormal and, for that matter, as yet undetectable levels of circulating TSH may exert stimulatory effects on thyroid tissue.

Authors

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Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

3088021

Citation

Spencer, C A., et al. "Thyrotropin Secretion in Thyrotoxic and Thyroxine-treated Patients: Assessment By a Sensitive Immunoenzymometric Assay." The Journal of Clinical Endocrinology and Metabolism, vol. 63, no. 2, 1986, pp. 349-55.
Spencer CA, Lai-Rosenfeld AO, Guttler RB, et al. Thyrotropin secretion in thyrotoxic and thyroxine-treated patients: assessment by a sensitive immunoenzymometric assay. J Clin Endocrinol Metab. 1986;63(2):349-55.
Spencer, C. A., Lai-Rosenfeld, A. O., Guttler, R. B., LoPresti, J., Marcus, A. O., Nimalasuriya, A., Eigen, A., Doss, R. C., Green, B. J., & Nicoloff, J. T. (1986). Thyrotropin secretion in thyrotoxic and thyroxine-treated patients: assessment by a sensitive immunoenzymometric assay. The Journal of Clinical Endocrinology and Metabolism, 63(2), 349-55.
Spencer CA, et al. Thyrotropin Secretion in Thyrotoxic and Thyroxine-treated Patients: Assessment By a Sensitive Immunoenzymometric Assay. J Clin Endocrinol Metab. 1986;63(2):349-55. PubMed PMID: 3088021.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thyrotropin secretion in thyrotoxic and thyroxine-treated patients: assessment by a sensitive immunoenzymometric assay. AU - Spencer,C A, AU - Lai-Rosenfeld,A O, AU - Guttler,R B, AU - LoPresti,J, AU - Marcus,A O, AU - Nimalasuriya,A, AU - Eigen,A, AU - Doss,R C, AU - Green,B J, AU - Nicoloff,J T, PY - 1986/8/1/pubmed PY - 1986/8/1/medline PY - 1986/8/1/entrez SP - 349 EP - 55 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 63 IS - 2 N2 - A new TSH immunoenzymometric assay was found to be capable of discriminating between the serum TSH values of normal subjects [2.28 +/- 1.02 (+/-SD); range, 0.6-6.5 microU/ml] and those of clinically euthyroid, antithyroid drug-treated (n = 22) or clinically thyrotoxic (n = 34) patients. While a wide spectrum of basal TSH values was found in the antithyroid drug group [ranging from undetectable (less than 0.05 microU/ml: 57%) to 17.9 microU/ml], all clinically thyrotoxic patients had undetectable values. In 33 patients receiving chronic oral T4 therapy for treatment of goiter (n = 15) or thyroid cancer (n = 18), 48% (6 of 33) had undetectable basal TSH levels and no TSH response to TRH stimulation. Detectable TSH levels were found in 42% (14 of 33), and TRH responsiveness was found in 52% (17 of 33). The TSH response to TRH stimulation was less than 2.0 microU/ml in 7 patients. Serum free T4 index, free T3 index, and free T4 levels and oral T4 dosage were inferior predictors of TRH responsiveness compared to the basal TSH value. No patient receiving more than 0.2 mg T4 daily or having a free T4 index above 18, a free T3 index above 205 or a free T4 level above 3.0 ng/dl had a TSH response to TRH. Seventy-six percent (16 of 21) of the patients, when reevaluated 1-6 weeks after increased oral T4 dosage, had a significant reduction in their serum thyroglobulin level. This was true of both patients with initially detectable (11 of 14) as well as undetectable (5 of 7) basal serum TSH levels. These findings support the concept that subnormal and, for that matter, as yet undetectable levels of circulating TSH may exert stimulatory effects on thyroid tissue. SN - 0021-972X UR - https://www.unboundmedicine.com/medline/citation/3088021/Thyrotropin_secretion_in_thyrotoxic_and_thyroxine_treated_patients:_assessment_by_a_sensitive_immunoenzymometric_assay_ DB - PRIME DP - Unbound Medicine ER -