Serum Iodine in Hypothyroidism Before and During Thyroid Therapy 12

Winkler, Alexander W.; Riggs, Douglas S.; Man, Evelyn B.

doi:10.1172/jci101658

Cited by 28 publications

(16 citation statements)

References 23 publications

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“…The points represent average values for increasing thyroid dosage in all 4 schizophrenic patients and for all increments of dose. concentration has been observed following thyroidectomy (patient B32017, and Figure 2 of the preceding paper) and following discontinuance of thyroid medication in patients with myxedema (1).…”

Section: Fig 5 Parallelism Bteween the Rate Of Change Of Serum Precmentioning

confidence: 83%

“…The changes in serum iodine and basal metabolic rate which occur when myxedematous patients are treated with desiccated thyroid have been reported in the preceding paper (1). Many euthyroid subjects differ from myxedematous patients in their ability to tolerate comparatively large amounts of dried thyroid without manifesting significant signs or symptoms of hypermetabolism (2).…”

mentioning

confidence: 87%

“…The dose in grains per day is indicated by the figures on the curves. The curve for the patients with myxedema was calculated from data reported in the preceding paper (1). Data from the 2 groups of euthyroid subjects reported here are plotted separately, the New Haven-Hospital patients being indicated by short dashes, the Fairfield State Hospital patients by long dashes.…”

Section: Fig 6 Relationship Between the Increase Of Serum Precipitamentioning

confidence: 99%

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Serum Iodine of Euthyroid Subjects Treated With Desiccated Thyroid 12

Riggs

Man²,

Winkler³

1945

J. Clin. Invest.

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The changes in serum iodine and basal metabolic rate which occur when myxedematous patients are treated with desiccated thyroid have been reported in the preceding paper (1). Many euthyroid subjects differ from myxedematous patients in their ability to tolerate comparatively large amounts of dried thyroid without manifesting significant signs or symptoms of hypermetabolism (2). In the present paper, the influence of thyroid feeding on serum iodine as well as on basal metabolism of euthyroid subjects is described, and the mechanism of euthyroid tolerance to large doses of desiccated thyroid is discussed. MATERIALS AND METHODSData from 2 groups of patients are presented. The first group consisted of 4 female schizophrenic patients in the Fairfield State Hospital, who were chosen for their willingness to cooperate in an extended experimental study. None of the 4 showed any evidence of thyroid dysfunction, and all were in reasonably good physical condition. The medical and psychiatric status of each patient is summarized at the end of the paper.The basal metabolic rate of each patient was determined once a week. Duplicate 8-minute tests were performed using the Sanborn Motor-Grafic metabolism apparatus. Patients were required to rest in bed for 1½ hours before the test. The lower of the 2 rates determined during each test period was used rather than the average of both readings. Basal metabolic rates of patients Pa., Ve., and Vi. were usually quite satisfactorily measured, those of Wi. less accurately. Body weight, pulse rate, oral temperature, and blood pressure were measured under basal conditions. Concentrations of precipitable iodine and of filtrable iodine in serum from venous blood were determined each week by methods previously described (3,4). If (5). Serum total cholesterol and serum titrated fatty acids were determined at monthly intervals by methods previously described (6, 7). Complete blood counts were done every 2 or 3 weeks throughout the course of the investigation. The first 5 weeks of the study of each patient constituted a control period. U.S.P. desiccated thyroid * was then given daily in powdered form as a suspension in a small amount of water under the close supervision of a graduate nurse or of an experienced head attendant. The dose was increased stepwise at 4-week intervals from 3 to 6, 10, 15, and finally to 20 or 25 grains per day. The highest dose was maintained for 6 to 8 weeks, and then abruptly discontinued. Thereafter the patients were followed until no further significant changes in serum iodine or basal metabolic rate were observed. Minor individual variations from the program outlined above appear in Figure 1.The second group consisted of 9 ambulatory patients followed for considerable periods of time in the metabolism clinic of the New Haven Hospital. The clinical status of each of these patients is described in the legend of Figure 2. Determinations of basal metabolic rate and serum total iodine were made at approximately monthly intervals. Barring unusual iodine intake, serum...

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Section: Fig 5 Parallelism Bteween the Rate Of Change Of Serum Precmentioning

confidence: 83%

mentioning

confidence: 87%

Section: Fig 6 Relationship Between the Increase Of Serum Precipitamentioning

confidence: 99%

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Serum Iodine of Euthyroid Subjects Treated With Desiccated Thyroid 12

Riggs

Man²,

Winkler³

1945

J. Clin. Invest.

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“…This in turn is based on the findings in clinical myxedema, in which a low concentration of iodine in serum was invariably found (7), and upon a study of the serum iodine in a series of several hundred subjects without hyperthyroidism in whom a low iodine concentration was never found (9). On the whole, the infernal evidence in this study confirms this interpretation of a depression of serum iodine, since most of the subjects had other evidences of thyroid deficiency and responde'd clinically to thyroid medication.…”

Section: Effects Of Iodine Medication Alonementioning

confidence: 99%

“…The concentration of precipitable 2 iodine in serum is a sensitive index of concentration of circulating thyroid hormone (1 to 7). The level of precipitable iodine is characteristically elevated in untreated hyperthyroidism (1 to 3,6) and tends to fall after iodine medication and after thyroidectomy (3).…”

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confidence: 99%

Serum Iodine in Hyperthyroidism, With Particular Reference to the Effects of Subtotal Thyroidectomy 1

Winkler¹,

Riggs²,

Thompson³

et al. 1946

J. Clin. Invest.

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The concentration of precipitable 2 iodine in serum is a sensitive index of concentration of circulating thyroid hormone (1 to 7). The level of precipitable iodine is characteristically elevated in untreated hyperthyroidism (1 to 3, 6) and tends to fall after iodine medication and after thyroidectomy (3). In the present study the changes following treatment were analyzed with special reference to the development of abnormally low or high levels of precipitable iodine at various intervals after operation. MATERIAL AND METHODSWhenever possible, total or precipitable iodine concentration in serum was measured before any treatment was given. Iodine medication in the form of strong solution of iodine U.S.P., 5 drops 3 times a day, was then given until the day of subtotal thyroidectomy, when it was discontinued. In a few instances the measurement of serum precipitable iodine concentration was repeated just before operation. At various intervals after subtotal thyroidectomy the concentration of iodine in serum was again de-termined. In many instances, including all those in whom the subtotal thyroidectomy was done prior to 1940, postoperative determinations alone were made. Only patients in whom the diagnosis of hyperthyroidism was established by a characteristic clinical picture and by subsequent pathological examination of the gland removed at operation are included. Basal metabolic rate and concentration of cholesterol in serum were also followed postoperatively.In the years during which these observations were made (1940( to Oct., 1944) the technical character of the operation of subtotal thyroidectomy in the New Haven Hospital was planned by one of the authors (K. W. Thompson). The majority of the operations were performed by him, or done under his direction by the resident 1 Aided by grants from the Fluid Research Fund of the Yale University School of Medicine.2The "precipitable" iodine includes all iodine which is precipitated along with the serum proteins. It is the same fraction which is sometimes referred to as "protein bound" or "hormonal" iodine. surgeon. A rather complete standardized thyroidectomy B was carried out in the belief that a radical operation would reduce the incidence of recurrent hyperthyroidism, which is regarded as a highly unfavorable outcome. About 140 operations for subtotal thyroidectomy were performed during this period. An initial determination of the serum total or precipitable iodine was made in 87 instances, and of the whole blood iodine in 26 more. At some time during the first 6 months after operation the serum iodine determination was repeated one or more times in 60 of these cases, which were selected more or less at random. After 6 months serum iodine determinations were made in only 32 of these cases.There were included also 51 additional cases whose operation had been done before 1940; in about half of these cases the subtotal thyroidectomy had been done in the New Haven Hospital before 1940. Unlike the studies during the first 6 postoperative months, many of these later st...

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Thyroxin and Triiodothyronine in Excessive Dosage to Euthyroid Humans

Beierwaltes¹,

Ruff²

1958

Arch Intern Med

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The comparative effects of 3,5,3'-l-triiodothyronine and l-thyroxin in myxedema have been carefully evaluated. days before starting triiodothyronine. Triiodothyronine was then given for 11 to 17 days in rapidly increasing doses to make the subjects "toxic." This medication in turn was stopped abruptly, and the patients were followed through a control period of 10 to 14 days. In the remaining six subjects triiodothyronine was given first, for 9 to 13 days, and thyroxin was given second, for 15 to 17 days.Dosage.- Table 2

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Serum Iodine in Hypothyroidism Before and During Thyroid Therapy 12

Cited by 28 publications

References 23 publications

Serum Iodine of Euthyroid Subjects Treated With Desiccated Thyroid 12

Serum Iodine of Euthyroid Subjects Treated With Desiccated Thyroid 12

Serum Iodine in Hyperthyroidism, With Particular Reference to the Effects of Subtotal Thyroidectomy 1

Thyroxin and Triiodothyronine in Excessive Dosage to Euthyroid Humans

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