Download PDF
Nuklearmedizin 1973; 12(03): 218-224
DOI: 10.1055/s-0038-1624823
Originalarbeiten — Original Articles — Travaux Originaux
Schattauer GmbH

A Rapid (48 hours) Thyroid Suppression Test using a Single Oral Dose of 100 of Triiodothyronine

Un test rapide (48 heures) de suppression thyroïdienne par application oral d’une dose unique de 100 μg de triiodothyronineEin schneller (48 Stunden) Schilddrüsen-Unterdrückungstest nach oraler Gabe einer Einzeldosis von 100 μg Trijodthyronin
Denis G. Ikkos
1   From the Department of Endocrinology and Radioisotopes Laboratory, Evangelismos Hospital, Athens
,
Elli Lakka - Papadodima
1   From the Department of Endocrinology and Radioisotopes Laboratory, Evangelismos Hospital, Athens
,
Constantin Ntalles   *
1   From the Department of Endocrinology and Radioisotopes Laboratory, Evangelismos Hospital, Athens
› Author Affiliations
Further Information

Publication History

Received:05 July 1973

Publication Date:
22 January 2018 (online)

Also available at
    Permissions and Reprints

Des mesurages répétés de la fixation thyroïdienne de 10 minutes du 132I injecté intraveineusement on été effectués sur 55 malades euthyroïdiens sans et avec goitre et sur 16 malades hyperthyreoïdiens par 4 jours consécutifs. Immédiatement après le premier mesurage tous les malades recevaient une dose unique oral de 100 μg de Triiodothyronine (T3). Les valeurs de fixation 24, 48 et 72 heures après le T3 (moyen ± déviation standard) étaient de 75 ± 1,7, 64 ± 1,8, et 67 ± 1,9 dans le groupe euthyroïdien et le 106 ± 2,6, 104 ± 2,2 et 108 ± 4,0 dans le groupe hyperthyroïdien, exprimés en pourcentage du groupe controle. 48 heures après T3 tous les personnes euthyroïdiens, sauf une, avaient des valeurs en dessous de 88% tandis que la valeur la plus basse des personnes hyperthyroïdiens ce jour était de 93%. La séparation des valeurs 48 heures des deux groupes était complète après avoir respecté l’influence de la première fixation sur la valeur 48 heures. On peut donc supposer q’un test thyroïdien de suppression utilisable en clinique peut-être effectué en 48 heures après une administration oral de 100 μg de T3 et mesurage de la fixation 10 minutes après l’injection du radioisotope.

Summary

Repeat measurements of the 10-min 132I thyroid uptake after i.v. administration of the isotope were performed daily for at least four consecutive days in 55 euthyroid goitrous or non-goitrous subjects and 16 hyperthyroid patients. Immediately after the first measurement all subjects were given a single oral dose of 100 µg of triiodothyronine (T3). The uptake values 24, 48 and 72 hours after T3 were (mean ± S.E.) for the euthyroid group 75 ± 1.7, 64 ± 1.8 and 67 ± 1.9 and for the hyperthyroid group 106 ± 2.6, 104 ± 2.2 and 108 ± 4.0 respectively, when the results were expressed in percent of the control values.

Forty-eight hours after T3 all euthyroid subjects - except one - had values lower than 88%, while the lowest value in the hyperthyroid subjects on that day was 93%. The separation of the 48 hours values of the two groups became complete when the effect of the initial uptake on the 48 hours value was taken into account. It is suggested, therefore, that a clinically useful T3 thyroid suppression test can be performed within 48 hours using a single oral dose of 100 fxg of T3 and the 10-min uptake after i.v. administration of the radioisotope.

Wiederholte Messungen der 10-min 132J-Speicherung der Schilddrüse nach intravenöser Verabreichung des Isotopes wurden täglich durch mindestens vier aufeinanderfolgende Tage bei 55 euthyreoten Personen, mit und ohne Kropf, und bei 16 hyperthyreoten Patienten durchgeführt. Unmittelbar nach der ersten Messung wurde allen Personen eine Einzeldosis von 100 μg Trijodthyronin (T3) oral verabreicht. Die Speicherwerte 24, 48 und 72 Stunden nach T3 betrugen (Durchschnitt ± Standardfehler) bei der euthyreoten Gruppe 75 ± 1,7, 64 ± 1,8 bzw. 67 ± 1,9 und bei der hyperthyreoten Gruppe 106 ± 2,6, 104 ± 2,2 bzw. 108 ± 4,0, wenn die Resultate als Prozentsatz der Kontrollwerte ausgedrückt wurden. 48 Stunden nach T3zeigten alle euthyreoten Personen, außer einer, Werte unter 88%, während der niedrigste Wert bei den hyperthyreoten Personen an diesem Tag 93% betrug. Die Trennung der 48-Stundenwerte der beiden Gruppen wurde vollständig, nachdem der Effekt der ersten Speicherung auf den 48-Stundenwert berücksichtigt wurde. Es ist daher anzunehmen, daß ein klinisch verwendbarer T3Schilddrüsen-Unterdrückungstest innerhalb 48 Stunden nach oraler Gabe von 100 (ig T3und mittels Bestimmung der 10-min Speicherung nach intravenöser Verabreichung des Radio-Isotöpes durchgeführt werden kann.

* Denis G. Ikkos: Head; Elli Lakka-Papadodima and Constantin Ntalles: assistant physicians, Department of Endocrinology and Radioisotopes, Evangelismos Hospital, Athens.


 

  • References

  • 1 Alexander W. D, McG RHarden, Shimmins J. Thyroidal suppression by triiodothyronine as a guide to the duration of treatment of thyrotoxicosis with antithyroid drugs. Lancet II 1041 1966;
    PubMedSearch in Google Scholar
  • 2 Alexander W. D, McG RHarden, Larty D, Shimmins J. Thyroidal suppressibility after stopping long term treatment of thyrotoxicosis with antithyroid drugs. Metabolism 1969; 18: 58.
    CrossrefPubMedSearch in Google Scholar
  • 3 Auger P, Saucier G, Drouin R, Paquet C, Brunet J. Test de suppression thyroidienne. Canad. med. Ass. J. 1965; 93: 962.
    PubMedSearch in Google Scholar
  • 4 Bakke J. L, Kammer H, Lawrence N. Effect of thyroid hormone on human pituitary thyroid-stimulating hormone. J. Clin. Endocr. 1964; 24: 281.
    CrossrefPubMedSearch in Google Scholar
  • 5 Bonnier G, Tedin O. Biologisk Variationsanalyse, Svenska Bokförlaget. Stockholm 1940
    PubMedSearch in Google Scholar
  • 6 Cassidy C.E. Use of a thyroid suppression test as a guide to prognosis of hyperthyroidism treated with antithyroid drugs. J. Clin. Endocr. 1965; 25: 155.
    PubMedSearch in Google Scholar
  • 7 Cassidy C. E, Wanderlaan W. P. Thyroid supppression test in the prognosis of hyperthyroidism treated by antithyroid drugs. New Engl. J. Med. 1960; 262: 1228.
    CrossrefPubMedSearch in Google Scholar
  • 8 Charkes N. D, Cantor R. E, Goluloff B. A three day, double isotope, 1-triiodothyronine suppression test of thyroid autonomy. J. Nucl. Med. 1967; 8: 627.
    PubMedSearch in Google Scholar
  • 9 Derome JCh, Mahaux Henry J. A. L'epreuve d'inhibition de la captation thyroidienne d'I-131 par la triiodothyronine chez les hyperthyroidiens et chez les euthyroidiens. Ann. Endocr. 1957; 18: 1030.
    PubMedSearch in Google Scholar
  • 10 Dresner S, Schneeberg N. G. Rapid radioiodine suppression test using triiodothyronine. J. Clin. Endocr. 1958; 18: 797.
    CrossrefPubMedSearch in Google Scholar
  • 11 Friis T. On the effect of 1-triiodothyronine on the thyroid gland and its clinical application (the triiodothyronine suppression test). Acta med. Scand 1963; 173: 569.
    Search in Google Scholar
  • 12 Greer M. A, Smith G. E. Method for increasing the accuracy of the radioiodine uptake as a test for thyroid function by the use of desiccated thyroid. J. Clin. Endocr. 1954; 14: 1374.
    CrossrefPubMedSearch in Google Scholar
  • 13 Guinet P, Decour C. Le test de Werner. Experience personelle. Gaz. med. Franç. 1963; 70: 421.
    Search in Google Scholar
  • 14 Hales I. B, Myhill J, Oddie T. H, and Croydon M. Quantitative observations with the triiodothyronine suppression test of thyroid function. J. Clin. Endocr. 1961; 21: 189.
    CrossrefPubMedSearch in Google Scholar
  • 15 Hales I. B, Myhill J, Oddie T. H, F. F R. und le Thyroid suppressibility after therapy for thyrotoxicosis. J. Clin. Endocr. 1961; 21: 569.
    CrossrefPubMedSearch in Google Scholar
  • 16 Hales I, Stiel J, Reeve T, Heap T, Myhill J. Prediction of the long term results of antithyroid drug therapy for thyrotoxicosis. J. Clin. Endocr. 1969; 29: 998.
    CrossrefPubMedSearch in Google Scholar
  • 17 Hamolsky M. W, Stein M, Freedberg A. S. The thyroid hormone-plasma protein complex in man. II A new in vitro method for study of "uptake" of labelled hormonal components by human erythrocytes. J. Clin. Endocr. 1957; 17: 33.
    Search in Google Scholar
  • 18 Hobbs J. R, Bayliss R. I. S, Maclagan N. F. The routine use of 132I in the diagnosis of thyroid diseases. Lancet I: 8 1963
    PubMedSearch in Google Scholar
  • 19 Ikkos D. G, Lakka-Papadodima E, Ntalles K. A new test of the reserve capacity of the pituitary to secrete thyrotropic hormone (TSH-reserve test). J. Clin. Endocr. 1970; 31: 98.
    CrossrefPubMedSearch in Google Scholar
  • 20 Ingbar S. H, Webber K. A. The thyroid gland. In Williams R. H. (ed). Textbook of Endocrinology. W. B. Saunders Company; Philadelphia and London: 1968. p. 171
    Search in Google Scholar
  • 21 Knopp C. T, Rennie M. H, Frenkel E. P, Korst D. R. The clinical application of thyroid stimulation and suppression tests. Amer. J. Med. Sei. 1962; 244: 316.
    CrossrefPubMedSearch in Google Scholar
  • 22 Kristensen H. P. O, Dyrbye M, Cristensen L. K. The triiodothyronine suppression test. Acta med. Scand. 1963; 173: 411.
    Search in Google Scholar
  • 23 Lawson J. D. The free Achilles reflex in hypothyroidism and hyperthyroidism. New Engl. J. Med. 1958; 259: 761.
    CrossrefPubMedSearch in Google Scholar
  • 24 Leistner J. H, Wersel C, Gronau U. Thyroid suppression test by means of Ts. Klin. Wschr. 1967; 45: 1241.
    CrossrefPubMedSearch in Google Scholar
  • 25 McCohaney W. M, Owen Jr. C. A. Studies on the inhibitory effect of l-tiiodothyronine on thyroidal I131 uptake in euthyroid persons and patients with exophthalmic goiter. J. Clin. Endocr. 1956; 16: 1480.
    CrossrefPubMedSearch in Google Scholar
  • 26 Mitchell M. L. Resin uptake of radiothyroxine in sera from nonpregnant and pregnant women. J. Clin. Endocr. 1958; 18: 1437.
    CrossrefPubMedSearch in Google Scholar
  • 27 Morgans M. E, Oldham A. K, Trotter W. R. The effect of exogenous thyroxine on radioiodine uptake in normal subjects and in cases of thyrotoxicosis in remission. J. Endocr. 1952; 8: 250.
    CrossrefPubMedSearch in Google Scholar
  • 28 Murphy B. P. The determination of thyroxine by competitive protein-binding analysis employing an anion-exchange resin and radiothyroxine. J. Lab. Clin. Med. 1965; 66: 161.
    Search in Google Scholar
  • 29 Murphy B. P, Pallee C. J. Determination of thyroxine utilizing the property of protein binding. J. Clin. Endocr. 1964; 24: 187.
    CrossrefPubMedSearch in Google Scholar
  • 30 Odell W. D, Wilber J. F, Utiger R. D. Studies on thyrotrophic hormone. Ree. Progr. Horm. Res. 1967; 23: 60.
    Search in Google Scholar
  • 31 Oddie T. H, F. F R, und le Thomas I. D, Hales I. B, Call B. Quantitative observations with the thyroxine suppression test of thyroid function. J. Clin. Endocr. 1960; 20: 1146.
    CrossrefPubMedSearch in Google Scholar
  • 32 Perlmutter M, Slater S. Use of thyroid hormone to differentiate between hyperthyroidism and euthyroidism. J. Amer. Med. Ass. 1955; 158: 718.
    CrossrefPubMedSearch in Google Scholar
  • 33 Singelakis P, Ikkos D. G, Gonticas S. C. A 6-days study of the effect of 100 Mg triiodothyronine (T3)/day on the early thyroid uptake of radioiodine in euthyroid and thyrotoxic subjects. Program of the 3rd Annual Meeting of the European Thyroid Association Athens 1969; p. 25.
    Search in Google Scholar
  • 34 Snedecor G. W. Statistical method applied to experiments in agriculture and biologyIowa State University Press, Ames, Iowa. 1964
    PubMedSearch in Google Scholar
  • 35 Spencer R.P, Henkelman C. R, King E. R. Thyroid parameters during triiodothyronine administration. Metabolism. 1958; 7: 119.
    PubMedSearch in Google Scholar
  • 36 Starr P, Liebhold-Schueck R. Effect of oral thyroxine and triiodothyronine on radioactive iodine uptake and serum protein-bound-iodine in normal subjects. Proc. Soc. Exper. Biol. Med. 1953; 83: 52.
    CrossrefPubMedSearch in Google Scholar
  • 37 Sterling K, Lashof J. C, Man E. B. Disappearance from serum of I-131 labelled l-thyroxine and l-triiodothyronine in euthyroid subjects. J. Clin. Invest. 1954; 33: 1031.
    CrossrefPubMedSearch in Google Scholar
  • 38 VanderLaan W. P, Cassidy C. The thyroid suppression test in the prognosis of hyperthyroidism treated with antithyroid drugs. J. Clin. Invest. 1959; 38: 1051.
    Search in Google Scholar
  • 39 Villela Pedras J. A, Penna Franca E, Penna Franca H. Our experience with the suppression test in the diagnosis of thyroid dysfunction (415 tests). Nucl. Med. 1963; 3: 263.
    Search in Google Scholar
  • 40 Werner S. C, Hamilton H, Nemeth M. Graves' disease: Hyperthyroidism or hyperpituitarism? J. Clin. Endocr. 1962; 12: 1561.
    Search in Google Scholar
  • 41 Werner S. C, Spooner M. A new and simple test for hyperthyroidism employing l-triiodothyronine and the twenty-four hour I131 uptake method. Bull. N. Y. Acad. Sei. 1955; 31: 137.
    Search in Google Scholar