Mild hyperthyroidism with inappropriate secretion of TSH in postmenopausal women

Abstract

In a previous study on the function of the hypothalamus -pituitary -thyroid axis, about 10% of postmenopausal women with the climacteric syndrome were found to have borderline high values of T3 and T4 and signs of pituitary decreased sensitivity to the suppressive effect of increased thyroid hormones. The present report concerns 5 women in the first phase of their menopause who showed a mild hyperthyroidism under basal conditions and after suppression test with liothyronine. Each patient had borderline increased levels of serum total and free T4 and T3 and a marked TSH responsiveness to exogenous TRH.After liothyronine, the serum levels of T4, FT4, TSH and the responsiveness to TRH-test clearly decreased. These data suggest an inappropriate TSH secretion with a decreased pituitary sentitivity to thyroid hormones.These cases could represent a modification of the hypothalamus-pituitary-thyroid axis associated with that of the gonadal axis, secondary to the absence of rapid adaptation of neurotransmitters.In a previous work we reported functional altera¬ tions in the hvpothalamus-pituitarv-thvroid axis during the first phase of the menopause (Custro et al. 1982).In the present study we selected women with borderline high values of serum T3 and T4. Such values are found in 10% of women menopaused for 1 to 5 vears and presenting a climacteric svndrome. This frequency is certainly higher than Requests for reprints:

Thyroid dysfunction in perimenopausal and postmenopausal women

“…Symptoms of hyperthyroidism may be difficult to distinguish from perimenopausal and postmenopausal symptoms. 50 For example, heat intolerance and palpitations due to thyrotoxicosis may be mistaken for hot flushes. Additionally, oligomenorrhoea occurs in about one in four women with thyrotoxicosis.…”