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Thyroid rebound


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Posted by: Mudge

People keep asking about this one.

N Engl J Med 1975 Oct 2;293(14):681-4

Recovery of pituitary thyrotropic function after withdrawal of prolonged thyroid-suppression therapy.

Vagenakis AG, Braverman LE, Azizi F, Portinay GI, Ingbar SH.

The pattern of thyrotropin secretion was analyzed in seven euthyroid women, before and after withdrawal of long-term thyroid hormone, by serial measurements of thyroid 131l uptake, serum thyroxine, tri-iodothyronine, and thyrotropin concentrations, and the response to thyrotropin-releasing hormone. During exogenous hormone administration, 131l uptake was suppressed, and serum thyrotropin concentrations before and after administration of thyrotropin-releasing hormone were undetectable.

After withdrawal of exogenous hormone, thyrotropin secretory function was transiently impaired, as indicated by undetectable basal thyrotropin concentrations together with absence of response to thyrotropin-releasing hormone, and subsequently by normal values of basal thyrotropin concentration and normal responses to releasing hormone while serum thyroxine and tri-iodothyronine concentrations were subnormal.

Decreased thyrotropin reserve persisted for two to five weeks. Detectable values of serum thyrotropin (less than 1.2 muU per milliliter) and a normal 131l uptake usually occurred concurrently in two to three weeks. Serum thyroxine concentration returned to normal at least four weeks after hormone withdrawal.



Posted by: Tha Don

can't this be avoided by tapering off?



Posted by: Mudge

Even a small amount causes suppression, but my whole point was whats the big deal with a couple weeks when you've been on for YEARS? People seem to think that hardcore shutdown is going to be a problem, I never had any rebound at all although I wasn't on for years, only 6 weeks.



Posted by: AusBB

I heard that it has a bigger shutdown effect on woman. Not sure how true that is.




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