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The effect of fenclofenac on thyroid function.

A B Kurtz, S J Capper, J Clifford

    Clinical Endocrinology
    |August 1, 1981
    PubMed
    Summary
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    Fenclofenac, an anti-inflammatory drug, significantly reduces thyroid hormone levels (T4 and T3) by inhibiting thyroxine-binding globulin. It also causes transient pituitary suppression, affecting thyrotropin and reverse T3 levels.

    Area of Science:

    • Endocrinology
    • Pharmacology

    Background:

    • Non-steroidal anti-inflammatory drugs (NSAIDs) can impact thyroid hormone homeostasis.
    • Thyroxine-binding globulin (TBG) is the primary carrier protein for thyroid hormones in circulation.

    Purpose of the Study:

    • To investigate the effects of fenclofenac on thyroid hormone levels and pituitary function in healthy male volunteers.
    • To determine the mechanism by which fenclofenac influences thyroid hormone binding to TBG.

    Main Methods:

    • A 4-week study involving eight male volunteers taking fenclofenac 600 mg twice daily.
    • Serum concentrations of total and free thyroxine (T4) and triiodothyronine (T3), thyrotropin, and reverse T3 were measured.
    • Response to thyrotropin-releasing hormone (TRH) was assessed to evaluate pituitary function.

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    Main Results:

    • Fenclofenac significantly reduced serum concentrations of total T4, total T3, and free T4.
    • A transient decrease in thyrotropin and an increase in reverse T3 were observed, suggesting pituitary suppression.
    • Thyroid hormone and thyrotropin levels returned to normal after discontinuing fenclofenac.

    Conclusions:

    • Fenclofenac competitively inhibits the binding of T4 and T3 to TBG, leading to decreased circulating thyroid hormone levels.
    • The drug induces transient pituitary suppression, indicated by altered thyrotropin and TRH response.
    • These effects are reversible upon cessation of fenclofenac therapy.