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Variable effects of nonsteroidal antiinflammatory agents on thyroid test results
M H Samuels1, K Pillote, D Asher
1Division of Endocrinology, Diabetes, and Clinical Nutrition, Oregon Health and Science University, Portland, Oregon 97201, USA. samuelsm@ohsu.edu
The Journal of Clinical Endocrinology and Metabolism
|December 13, 2003
Summary
Certain nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and salsalate can alter thyroid hormone levels, while others such as ibuprofen do not. Thyroid-stimulating hormone (TSH) remained stable across all tested NSAIDs.
Area of Science:
- Endocrinology
- Pharmacology
- Clinical Chemistry
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for pain and inflammation.
- The impact of various NSAIDs on thyroid function tests is not fully understood.
- Thyroid hormone levels and thyroid-stimulating hormone (TSH) are critical indicators of thyroid health.
Purpose of the Study:
- To investigate the effects of commonly used NSAIDs on thyroid hormone measurements.
- To identify which NSAIDs influence thyroid tests and which do not.
Main Methods:
- A study involving 25 healthy subjects, including a single-dose and a 1-week administration of six different NSAIDs (aspirin, salsalate, meclofenamate, ibuprofen, naproxen, indomethacin).
- Analysis of total and free thyroid hormones (T4 and T3) and TSH using RIA, equilibrium dialysis, and immunometric assays.
- Measurements were taken at multiple time points after single doses and daily during 1-week administration.
Main Results:
- Ibuprofen, naproxen, and indomethacin did not alter thyroid hormone levels or TSH after single or 1-week use.
- Single-dose aspirin or salsalate decreased thyroid hormone measurements; meclofenamate increased them.
- One week of aspirin or salsalate decreased total T4, free T4 (salsalate only), total T3, free T3, and TSH.
- TSH levels remained within the normal range throughout the study for all NSAIDs.
Conclusions:
- Aspirin, salsalate, and meclofenamate demonstrably affect thyroid hormone measurements.
- Ibuprofen, naproxen, and indomethacin appear to be safe regarding thyroid function tests.
- Clinicians should be aware of potential NSAID-induced alterations in thyroid hormone levels, particularly with aspirin, salsalate, and meclofenamate.