Abstract
There are many biochemical and clinical findings in patients with anorexia nervosa to suggest altered thyroid hormone activity but laboratory tests of thyroid gland function are generally normal or low normal. TSH, total T4, total T3 and the response to TRH were determined in 6 patients with anorexia nervosa in an effort to evaluate discriminately thyroid hormone activity at the physiologic levels of the hypothalamus, pituitary gland, thyroid gland and peripheral tissue. The results, expressed as the mean value ± SEM, are summarized in the following table:
The most striking finding was the markedly depressed T3 levels. Animal studies suggest that in acute starvation, peripheral deiodination of thyroxine is increased. Our data suggest that during chronic starvation, peripheral deiodination of T4 to T3 is diminished. Sullivan et al have suggested that severely ill but euthyroid patients have decreased deiodination and decreased intracellular T3. Teleologically, decreased deiodination may be a protective mechanism during chronic stress.
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Moshang, T., Parks, J., Vaidya, V. et al. LOW LEVELS OF TRIIODOTHYRONINE IN ANOREXIA NERVOSA. Pediatr Res 8, 372 (1974). https://doi.org/10.1203/00006450-197404000-00192
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DOI: https://doi.org/10.1203/00006450-197404000-00192