Glucocorticoid Functional Reserve in Full-Spectrum Intensity of Primary Hypothyroidism
Adrenal function might be impaired in patients with primary hypothyroidism. The objective was to evaluate adrenocortical function using the low-dose cosyntropin test in patients with primary hypothyroidism. Consequently a prospective, longitudinal, controlled study of sixty adult patients with prima...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2014/313519 |
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| author | René Rodríguez-Gutiérrez Camilo González-Velázquez Gerardo González-Saldívar Jesús Zacarías Villarreal-Pérez José Gerardo González-González |
| author_facet | René Rodríguez-Gutiérrez Camilo González-Velázquez Gerardo González-Saldívar Jesús Zacarías Villarreal-Pérez José Gerardo González-González |
| author_sort | René Rodríguez-Gutiérrez |
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| description | Adrenal function might be impaired in patients with primary hypothyroidism. The objective was to evaluate adrenocortical function using the low-dose cosyntropin test in patients with primary hypothyroidism. Consequently a prospective, longitudinal, controlled study of sixty adult patients with primary hypothyroidism was carried out. Patients naïve to L-T4 treatment were compared with control participants. A low-dose cosyntropin test was done before and after L-T4 therapy. Thirty and sixty minutes after the low-dose cosyntropin, the mean cortisol values were lower in the cases group (612.6 ± 133.1 and 603.4 ± 153.7 nmol/L) when compared to the control group (677.0 ± 82.4 and 669.9 ± 83.7 nmol/L) (P=0.001 and 0.003), respectively. After L-T4 therapy, this difference was lost. Four out of 60 cases (6.7%) taking a cortisol cutoff value of 500 mmol/L and 11 out of 60 (18.3%) having 550 mmol/L as the cutoff had adrenal insufficiency before L-T4 therapy. After L-T4 therapy, 50% and 81% of the cases had normal cortisol response. In conclusion, patients with different degrees of intensity of primary hypothyroidism had improved cortisol response after reaching euthyroidism. The incidence of adrenal insufficiency was 6.7–18.3% and more than 50% of the cases had a normal cortisol response after L-T4 therapy. |
| format | Article |
| id | doaj-art-9380363e91a144ac863c5b38364b1be9 |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-9380363e91a144ac863c5b38364b1be92025-02-03T01:30:05ZengWileyInternational Journal of Endocrinology1687-83371687-83452014-01-01201410.1155/2014/313519313519Glucocorticoid Functional Reserve in Full-Spectrum Intensity of Primary HypothyroidismRené Rodríguez-Gutiérrez0Camilo González-Velázquez1Gerardo González-Saldívar2Jesús Zacarías Villarreal-Pérez3José Gerardo González-González4Endocrinology Division, Internal Medicine Department, University Hospital “Dr. José E. González”, Facultad de Medicina, Universidad Autónoma de Nuevo León, Avenida Madero y Avenida Gonzalitos s/n, Colonia Mitras Centro, 64460 Monterrey, NL, MexicoInternal Medicine Department, University Hospital “Dr. José E. González”, Facultad de Medicina, Universidad Autónoma de Nuevo León, Avenida Madero y Avenida Gonzalitos s/n, Colonia Mitras Centro, 64460 Monterrey, NL, MexicoInternal Medicine Department, University Hospital “Dr. José E. González”, Facultad de Medicina, Universidad Autónoma de Nuevo León, Avenida Madero y Avenida Gonzalitos s/n, Colonia Mitras Centro, 64460 Monterrey, NL, MexicoEndocrinology Division, Internal Medicine Department, University Hospital “Dr. José E. González”, Facultad de Medicina, Universidad Autónoma de Nuevo León, Avenida Madero y Avenida Gonzalitos s/n, Colonia Mitras Centro, 64460 Monterrey, NL, MexicoEndocrinology Division, Internal Medicine Department, University Hospital “Dr. José E. González”, Facultad de Medicina, Universidad Autónoma de Nuevo León, Avenida Madero y Avenida Gonzalitos s/n, Colonia Mitras Centro, 64460 Monterrey, NL, MexicoAdrenal function might be impaired in patients with primary hypothyroidism. The objective was to evaluate adrenocortical function using the low-dose cosyntropin test in patients with primary hypothyroidism. Consequently a prospective, longitudinal, controlled study of sixty adult patients with primary hypothyroidism was carried out. Patients naïve to L-T4 treatment were compared with control participants. A low-dose cosyntropin test was done before and after L-T4 therapy. Thirty and sixty minutes after the low-dose cosyntropin, the mean cortisol values were lower in the cases group (612.6 ± 133.1 and 603.4 ± 153.7 nmol/L) when compared to the control group (677.0 ± 82.4 and 669.9 ± 83.7 nmol/L) (P=0.001 and 0.003), respectively. After L-T4 therapy, this difference was lost. Four out of 60 cases (6.7%) taking a cortisol cutoff value of 500 mmol/L and 11 out of 60 (18.3%) having 550 mmol/L as the cutoff had adrenal insufficiency before L-T4 therapy. After L-T4 therapy, 50% and 81% of the cases had normal cortisol response. In conclusion, patients with different degrees of intensity of primary hypothyroidism had improved cortisol response after reaching euthyroidism. The incidence of adrenal insufficiency was 6.7–18.3% and more than 50% of the cases had a normal cortisol response after L-T4 therapy.http://dx.doi.org/10.1155/2014/313519 |
| spellingShingle | René Rodríguez-Gutiérrez Camilo González-Velázquez Gerardo González-Saldívar Jesús Zacarías Villarreal-Pérez José Gerardo González-González Glucocorticoid Functional Reserve in Full-Spectrum Intensity of Primary Hypothyroidism International Journal of Endocrinology |
| title | Glucocorticoid Functional Reserve in Full-Spectrum Intensity of Primary Hypothyroidism |
| title_full | Glucocorticoid Functional Reserve in Full-Spectrum Intensity of Primary Hypothyroidism |
| title_fullStr | Glucocorticoid Functional Reserve in Full-Spectrum Intensity of Primary Hypothyroidism |
| title_full_unstemmed | Glucocorticoid Functional Reserve in Full-Spectrum Intensity of Primary Hypothyroidism |
| title_short | Glucocorticoid Functional Reserve in Full-Spectrum Intensity of Primary Hypothyroidism |
| title_sort | glucocorticoid functional reserve in full spectrum intensity of primary hypothyroidism |
| url | http://dx.doi.org/10.1155/2014/313519 |
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