Reversible subclinical hypothyroidism in the presence of adrenal insufficiency.

Academic Article


  • OBJECTIVE: To describe 3 different scenarios of reversible hypothyroidism in young patients with adrenal insufficiency. METHODS: We present 3 case reports of patients with adrenal insufficiency--one with delayed puberty, the second with type 1 diabetes and poor weight gain, and the third with hypoglycemia-related seizures and glucocorticoid deficiency--who had biochemical evidence of hypothyroidism. RESULTS: Our first patient (case 1) initially had a mildly elevated thyrotropin (thyroid-stimulating hormone or TSH) level and a normal free thyroxine (FT4) level that, on follow-up assessment, had progressed to persistent mild elevation of TSH and low FT4 concentration. The other 2 patients (cases 2 and 3) had low FT4 and mildly elevated TSH values at the time of diagnosis of adrenal insufficiency. In all 3 patients, the results of thyroid function tests normalized with use of physiologic doses of adrenal hormone replacement therapy, without thyroid hormone replacement. All 3 patients remained euthyroid after 4, 3, and 1 year of follow-up, respectively. CONCLUSION: These observations add insights into the complexities of the thyroadrenal interactions. These examples are important because thyroid hormone replacement in the setting of adrenal insufficiency could be unwarranted.
  • Authors

    Published In

  • Endocrine Practice  Journal
  • Keywords

  • Adolescent, Adrenal Cortex Hormones, Adrenal Insufficiency, Child, Child, Preschool, Drug Administration Schedule, Female, Humans, Hydrocortisone, Hypothyroidism, Male, Thyrotropin, Thyroxine, Treatment Outcome
  • Digital Object Identifier (doi)

    Author List

  • Abdullatif HD; Ashraf AP
  • Start Page

  • 572
  • Volume

  • 12
  • Issue

  • 5