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Thyroid-stimulating hormone (TSH), triiodothyronine (T3) and thyroxine (T4) response to intravenous and oral stimulation with synthetic thyrotropin-releasing hormone (TRH) in young healthy adults

Plasma-TSH (Thyreoidea-stimulierendes Hormon), T4 (Thyroxin) und T3 (Trijodothyronin)-Reaktion nach oraler und intravenöser Stimulation mit TRH (thyrotropin-releasing-hormon)

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Zusammenfassung

Die Plasma TSH, T3 und T4 Reaktion auf Stimulation mit dem synthetischen thyrotropin-releasing-hormone (TRH) wurde bei 24 jungen gesunden Erwachsenen nach intravenöser Stimulation mit 200 µg TRH und bei 25 gesunden jungen Erwachsenen nach oraler Stimulation mit 1–3 maliger Applikation von 40 mg TRH untersucht. Nach intravenöser Stimulation steigt die TSH Konzentration innert 30 min auf einen Maximalwert von im Mittel 11,7 µE/ml an. Der T3 Anstieg von 1,17auf 1,62 ng/ml nach 2 h ist statistisch signifikant aber im Einzeltest diagnostisch nicht verwertbar. Ein signifikanter Geschlechtsunterschied konnte in der vorliegenden Untersuchung weder für die TSH noch für die T3 Reaktion gefunden werden. Nach oraler Stimulation wird ein etwas höherer maximaler TSH Wert von 13,2 µE/ml 3 h nach der Applikation gefunden. Der T3 Anstieg auf 2,19 ng/ml ist statistisch signifikant und diagnostisch verwertbar. Die Zunahme der Thyroxinkonzentration nach 8 h oder 3 h nach der dritten TRH Dosis ist statistisch signifikant.

Die nach intravenöser Stimulation gefundenen Werte stimmen gut mit den bisherigen Ergebnissen in der Literatur überein. Während die Untersuchungen an größeren gesunden Kollektiven für die intravenöse Stimulation eher spärlich sind, fehlen sie für die orale Stimulation praktisch ganz. Dreimalige repetierte Stimulation mit je 40 mg TRH über 24 h ergeben nach der dritten Dosis eine geringere TSH Stimulation auf nur 5,8 µE/ml bei einer vergleichbaren Zunahme der T3 Konzentration.

Summary

TSH, T3 and T4 response to stimulation with thyrotropin releasing hormone (TRH) has been investigated in 24 young healthy adults after intravenous injection and in 25 young healthy adults upon oral application of 40 mg of TRH. After intravenous injection the TSH concentration raises from a mean of 1.6 to a mean maximum of 11.7µU/ml. A statistically significant sex difference could not be found. T3 shows a statistically significant increase which is however too small to be of diagnostic value in an individual test.

After oral stimulation with 40 mg of TRH, TSH rises to a slightly higher maximum of 13.2 µU/ml after 3 h. The T3 increase from 1.5 to 2.19 ng/ml is significant and considerably higher than after intravenous stimulation. The thyroxin increase is statistically significant.

The present results compare well with previously published data for intravenous stimulation. The oral route of TRH application has not yet been widely used and the present series establishes the normal response in young healthy adults.

Repetitive stimulation with three times 40 mg of TRH leads to a decrease in TSH stimulation which reaches 5.8 µU/ml 3 h after the third dose. This is in contrast to a comparable increase in plasma T3.

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Authors and Affiliations

  1. Department of Endocrinology, University Childrens' Hospital and Nuclear Medicine, University Medical Clinic Basel, Switzerland

    P. Vogt,  J. Girard & J. J. Staub

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  2. J. Girard
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  3. J. J. Staub
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Vogt, P., Girard, J. & Staub, J.J. Thyroid-stimulating hormone (TSH), triiodothyronine (T3) and thyroxine (T4) response to intravenous and oral stimulation with synthetic thyrotropin-releasing hormone (TRH) in young healthy adults. Klin Wochenschr 56, 31–35 (1978). https://doi.org/10.1007/BF01476740

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