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Prospective studies of thyroid function in patients receiving gold therapy
S J Mandel1, G A Brent, M Weinblatt
1Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Summary
Gold compounds do not significantly impact thyroid function in patients. This study found no correlation between gold dosage and thyroid hormone levels, suggesting safety for thyroid health.
Area of Science:
- Endocrinology
- Pharmacology
- Rheumatology
Background:
- Gold compounds are known to inhibit Type I deiodinase, an enzyme crucial for circulating triiodothyronine (T3) production.
- Understanding the impact of gold therapy on thyroid function is important for managing patients with autoimmune conditions.
Purpose of the Study:
- To prospectively evaluate the effect of increasing cumulative doses of parenteral gold on thyroid function in patients with rheumatoid or psoriatic arthritis.
Main Methods:
- Eight euthyroid patients initiating intramuscular gold therapy were enrolled.
- Serum levels of total thyroxine (T4), triiodothyronine (T3), reverse triiodothyronine (rT3), and thyroid-stimulating hormone (TSH) were monitored.
- Free T4 and free T3 indices, TSH concentrations, and T4/T3 ratios were correlated with cumulative gold dose.
Main Results:
- No significant correlation was found between cumulative gold dose and any measured thyroid function parameters (free T4 index, free T3 index, TSH, T4/T3 ratio).
- Linear regressions, both individual and pooled, did not demonstrate a significant relationship.
Conclusions:
- Parenteral gold compounds, up to 1500 mg, do not appear to affect thyroid function in patients.
- Gold's primary accumulation in Kupffer cells and renal cortex, which lack Type I deiodinase, likely explains the absence of thyroid impact.