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Related Experiment Videos

Hyperthyroxinemia in patients treated with high-dose propranolol.

D S Cooper, G H Daniels, P W Ladenson

    The American Journal of Medicine
    |December 1, 1982
    PubMed
    Summary

    High-dose propranolol can cause hyperthyroxinemia by blocking thyroid hormone deiodination, mimicking hyperthyroidism. Further thyroid function tests are crucial for accurate diagnosis in patients taking this medication.

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    Area of Science:

    • Endocrinology
    • Pharmacology
    • Internal Medicine

    Background:

    • Hyperthyroxinemia can be mistaken for hyperthyroidism.
    • Propranolol is commonly used for angina pectoris.

    Purpose of the Study:

    • To investigate the cause of hyperthyroxinemia in patients taking high-dose propranolol.
    • To assess the diagnostic utility of thyroid function tests in this context.

    Main Methods:

    • Evaluation of six patients with hyperthyroxinemia on high-dose propranolol.
    • Measurement of serum free thyroxine, free thyroxine index, triiodothyronine, and reverse triiodothyronine.
    • Thyroid-stimulating hormone response to thyrotropin-releasing hormone testing.
    • Restudy of one patient on low-dose propranolol.

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    Main Results:

    • Patients exhibited elevated free thyroxine and/or free thyroxine index, low-normal triiodothyronine, and elevated reverse triiodothyronine.
    • Thyroid-stimulating hormone response to thyrotropin-releasing hormone was variable.
    • Thyroid function normalized upon reduction of propranolol dosage.

    Conclusions:

    • High-dose propranolol can induce hyperthyroxinemia by inhibiting iodothyronine deiodination.
    • Clinical signs of hyperthyroidism are absent in these patients.
    • Comprehensive thyroid function evaluation, including the thyrotropin-releasing hormone test, is essential to differentiate drug-induced abnormalities from true thyrotoxicosis.