Thyrotropin Response to Thyrotropin-releasing Hormone in Elderly Patients with and without Acute Illness

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Abstract
The response of thyrotropin (TSH) to thyrotropin-releasing hormone (TRH) was measured in 70 clinically euthyroid elderly patients who were acutely ill and in 70 age- and sex-matched euthyroid controls who were free of acute disease. The incremental TSH response (ΔTSH) was often blunted (< 2 mU/1) in both groups, though more often in those with acute illness (30%) than in those without (19%). However, in patients from both groups who had a blunted ΔTSH, there was often a substantial proportional rise in TSH. A substantial proportional TSH rise may be useful in differentiating between genuine thyroid disease and euthyroid sick syndrome in elderly patients with a blunted ΔTSH.

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