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Intermittent hyperthyreosis -- a heat stress syndrome
Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme
|September 1, 1975
Summary
Intermittent hyperthyroidism, often triggered by heat stress, presents with varied symptoms. Diagnosis relies on patient history and specific urinary tests, with urinary thyroxine being the most reliable indicator.
Area of Science:
- Endocrinology
- Environmental Medicine
- Bioclimatology
Background:
- Intermittent hyperthyroidism can manifest subtly under stress, particularly heat stress, often misdiagnosed.
- Standard diagnostic tests may yield inconsistent results, necessitating a focus on patient history and specific biomarkers.
Purpose of the Study:
- To identify key diagnostic indicators for intermittent hyperthyroidism, especially in heat-sensitive individuals.
- To evaluate the utility of urinary neurohormone determination in differentiating this condition.
Main Methods:
- Analysis of over 100 cases of heat-induced thyroid hypersensitivity.
- Clinical assessment focusing on patient anamnesis and reported symptoms during heat spells.
- Determination of urinary neurohormones, including histamine and thyroxine (T-4), alongside heart rate monitoring.
Main Results:
- A significant subset (10-15%) of weather-sensitive patients exhibit thyroid hypersensitivity to heat.
- Cardinal symptoms suggestive of intermittent hyperthyroidism include tachycardia (>80 bpm), elevated urinary histamine (>90 mug/day), and elevated urinary thyroxine (>20 mug/day).
- Urinary thyroxine excretion is identified as the sole specific diagnostic marker.
Conclusions:
- Intermittent hyperthyroidism due to heat stress is a distinct syndrome requiring careful clinical evaluation.
- Urinary thyroxine measurement is crucial for accurate diagnosis, differentiating it from other conditions with overlapping symptoms.
- Treatment typically involves lithium carbonate and beta-blockers, with propylthiouracil used sparingly.