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Sustained rises in serum thyrotropin, thyroxine, and triiodothyronine during long term, continuous thyrotropin-releasing hormone treatment in patients with amyotrophic lateral sclerosis.
J Clin Endocrinol Metab. 1986 Oct; 63(4):808-14.JC

Abstract

In a pilot therapeutic trial, four patients with amyotrophic lateral sclerosis (ALS) were treated with long term, continuous infusions of TRH, three intrathecally and one epidurally. They had prompt increases in serum TSH and thyroid hormone concentrations, averaging 120% for TSH, 49% for serum T4, 68% for the serum free T4 index, 49% for serum T3, and 67% for the serum free T3 index. These elevations were statistically significant for all but serum T3 and persisted for the duration of treatment (4-7 months). Mean values during treatment were near the upper limit of normal for each of these hormone measurements. After TRH withdrawal, serum TSH fell transiently below the normal range. A comparison group of four patients with ALS treated by twice weekly intrathecal bolus doses of TRH had no significant changes in serum TSH, T4, or T3. During continuous TRH treatment, the responsiveness of both TSH and PRL to a standard iv TRH stimulation test was blunted, but not abolished. Basal serum PRL was occasionally elevated in the two women during continuous TRH treatment, but was normal in the men, and serum GH was normal in all patients. In the patients receiving continuous TRH treatment, indexes of end-organ effects of thyroid hormone were inconclusive; none had a rise in serum ferritin, one of four had a rise in serum sex hormone-binding globulin, and three had increased creatinuria. These results provide direct evidence in man that chronic TRH administration can cause modest sustained increases in serum TSH and thyroid hormones, though the metabolic consequences of these changes are uncertain, and appears to raise the set-point of the pituitary-thyroid axis, i.e. the serum T4 and T3 concentrations needed for a given degree of suppression of basal TSH secretion.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

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

3091628

Citation

Kaplan, M M., et al. "Sustained Rises in Serum Thyrotropin, Thyroxine, and Triiodothyronine During Long Term, Continuous Thyrotropin-releasing Hormone Treatment in Patients With Amyotrophic Lateral Sclerosis." The Journal of Clinical Endocrinology and Metabolism, vol. 63, no. 4, 1986, pp. 808-14.
Kaplan MM, Taft JA, Reichlin S, et al. Sustained rises in serum thyrotropin, thyroxine, and triiodothyronine during long term, continuous thyrotropin-releasing hormone treatment in patients with amyotrophic lateral sclerosis. J Clin Endocrinol Metab. 1986;63(4):808-14.
Kaplan, M. M., Taft, J. A., Reichlin, S., & Munsat, T. L. (1986). Sustained rises in serum thyrotropin, thyroxine, and triiodothyronine during long term, continuous thyrotropin-releasing hormone treatment in patients with amyotrophic lateral sclerosis. The Journal of Clinical Endocrinology and Metabolism, 63(4), 808-14.
Kaplan MM, et al. Sustained Rises in Serum Thyrotropin, Thyroxine, and Triiodothyronine During Long Term, Continuous Thyrotropin-releasing Hormone Treatment in Patients With Amyotrophic Lateral Sclerosis. J Clin Endocrinol Metab. 1986;63(4):808-14. PubMed PMID: 3091628.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sustained rises in serum thyrotropin, thyroxine, and triiodothyronine during long term, continuous thyrotropin-releasing hormone treatment in patients with amyotrophic lateral sclerosis. AU - Kaplan,M M, AU - Taft,J A, AU - Reichlin,S, AU - Munsat,T L, PY - 1986/10/1/pubmed PY - 1986/10/1/medline PY - 1986/10/1/entrez SP - 808 EP - 14 JF - The Journal of clinical endocrinology and metabolism JO - J. Clin. Endocrinol. Metab. VL - 63 IS - 4 N2 - In a pilot therapeutic trial, four patients with amyotrophic lateral sclerosis (ALS) were treated with long term, continuous infusions of TRH, three intrathecally and one epidurally. They had prompt increases in serum TSH and thyroid hormone concentrations, averaging 120% for TSH, 49% for serum T4, 68% for the serum free T4 index, 49% for serum T3, and 67% for the serum free T3 index. These elevations were statistically significant for all but serum T3 and persisted for the duration of treatment (4-7 months). Mean values during treatment were near the upper limit of normal for each of these hormone measurements. After TRH withdrawal, serum TSH fell transiently below the normal range. A comparison group of four patients with ALS treated by twice weekly intrathecal bolus doses of TRH had no significant changes in serum TSH, T4, or T3. During continuous TRH treatment, the responsiveness of both TSH and PRL to a standard iv TRH stimulation test was blunted, but not abolished. Basal serum PRL was occasionally elevated in the two women during continuous TRH treatment, but was normal in the men, and serum GH was normal in all patients. In the patients receiving continuous TRH treatment, indexes of end-organ effects of thyroid hormone were inconclusive; none had a rise in serum ferritin, one of four had a rise in serum sex hormone-binding globulin, and three had increased creatinuria. These results provide direct evidence in man that chronic TRH administration can cause modest sustained increases in serum TSH and thyroid hormones, though the metabolic consequences of these changes are uncertain, and appears to raise the set-point of the pituitary-thyroid axis, i.e. the serum T4 and T3 concentrations needed for a given degree of suppression of basal TSH secretion. SN - 0021-972X UR - https://www.unboundmedicine.com/medline/citation/3091628/Sustained_rises_in_serum_thyrotropin_thyroxine_and_triiodothyronine_during_long_term_continuous_thyrotropin_releasing_hormone_treatment_in_patients_with_amyotrophic_lateral_sclerosis_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jcem-63-4-808 DB - PRIME DP - Unbound Medicine ER -