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High TSH concentrations in "euthyroidism": explanation based on control-loop theory.

T J Wilkin, B E Storey, T E Isles

    British Medical Journal
    |April 16, 1977
    PubMed
    Summary
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    Elevated thyroid-stimulating hormone (TSH) in euthyroid patients with reduced thyroid function was confirmed. This study explores the servo-control mechanism linking thyroid reserve to TSH levels in post-thyroidectomy and lithium-treated patients.

    Area of Science:

    • Endocrinology
    • Thyroidology
    • Neuropsychiatry

    Background:

    • Elevated serum thyroid-stimulating hormone (TSH) is observed in euthyroid individuals with compromised thyroid function.
    • This phenomenon has been noted in patients post-thyroidectomy and those on lithium therapy, both conditions associated with reduced thyroid reserve.

    Purpose of the Study:

    • To confirm the presence of high TSH concentrations in apparently euthyroid patients with reduced thyroid reserve.
    • To investigate the underlying mechanism using servo-control principles, linking thyroid capacity to TSH levels.

    Main Methods:

    • Confirmation of high TSH in two patient groups: 14 patients 18 months post-subtotal thyroidectomy for Graves' disease and 14 patients with manic-depressive psychosis on lithium carbonate.
    • Comparison with control groups to identify common factors.

    Related Experiment Videos

  • Application of physical servo-control principles to model TSH variation relative to functioning thyroid capacity.

    • Main Results:

    • Confirmed high serum TSH concentrations in both patient groups compared to controls.
    • Identified reduced thyroid reserve as a common factor in both groups.
    • Projected theoretical curves illustrating the relationship between TSH and thyroid functioning capacity.

    Conclusions:

    • Reduced thyroid reserve is a key factor associated with elevated TSH in euthyroid patients.
    • The study provides a theoretical framework based on servo-control principles to explain the observed TSH elevations.
    • Further investigation into thyroid reserve and TSH regulation is warranted.