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Case report: abnormal thyroid function tests in a patient and two normal volunteers treated with salsalate
B B Latham1, E Horst, H Nankin
1Medical Service, WJB Dorn Veterans' Hospital, Columbia, South Carolina.
The American Journal of the Medical Sciences
|February 1, 1993
Summary
Salsalate, a salicylate ester, can rapidly lower thyroid hormone levels, potentially causing hypothyroidism. Thyroid function tests normalized after discontinuing salsalate, highlighting its impact on thyroid health.
Area of Science:
- Endocrinology
- Pharmacology
- Clinical Medicine
Background:
- Abnormal thyroid function tests are rarely reported with salsalate use.
- Salsalate is the salicylate ester of salicylic acid.
Observation:
- An elderly, euthyroid man on salsalate showed central hypothyroidism indicators.
- Thyroid tests normalized upon salsalate discontinuation.
- Two volunteers taking salsalate exhibited rapid decreases in total T4 and free T4 (FT4).
Findings:
- Salsalate rapidly suppressed total T4 and FT4 levels within 24 hours.
- Thyroid hormone suppression persisted for at least 24 hours post-salsalate.
- Potential for falsely low FT4 measurements with equilibrium dialysis or diluted serum assays was noted.
Implications:
- This study highlights a previously undescribed rapid effect of salsalate on thyroid function.
- Ultrafiltration may be the most reliable method for FT4 measurement in patients taking salsalate.
- Clinicians should consider salsalate's impact on thyroid function tests.