GRAVES' DISEASE: HYPERTHYROIDISM OR HYPERPITUITARISM?*†

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Abstract
Thyrotropin and thyroid were admd. to patients with active, otherwise-untreated Graves" disease, and to patients recently brought into a state of remission with I131, to test the hypothesis that hyperthyroidism is the result of hyperpituitarism. Thyrotropin produced an increased release of hormone from the thyroid in active Graves" disease as judged by an increase in the serum precipitable iodine (SPI) level, whereas thyroid admn. did not depress the hyperthyroid gland as judged by the 24-hr. uptake of radioiodine. Thyrotropin produced a slight rise in the level of SPI in I131 -treated Graves" disease. Thyroid by mouth decreased the 24-hr. uptake of I131. These data tend to indicate that hyperthyroidism arises from mechanisms not mediated through the anterior pituitary.

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