SERUM TSH AND THYROID ANTIBODY STUDIES IN ADDISON'S DISEASE

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Abstract
SUMMARY: Thirty‐three patients with Addison's disease have been investigated with particular reference to thyroid function, thyroid antibody status and serum TSH measurements.Of twenty‐seven patients with idopathic or probably idiopathic Addison's disease, fifteen had antibodies against adrenal tissue and thirteen had thyroid microsomal antibodies. No patient with tuberculous Addison's disease had evidence of thyroid disease or of either adrenal or thyroid antibodies.The response to injected TSH was usually impaired in patients who had antithyroid antibodies in their serum. This test was cumbersome but appeared to indicate the reserve capacity of the thyroid.Serum TSH levels were raised in ten of the thirteen patients who had thyroid antibodies, including six whose protein bound‐iodine levels were below 4.0μ/100 ml. Three antibody negative subjects also had an elevated TSH level.The most sensitive indication of subclinical thyroid disease appeared to be a positive thyroid antibody test. Estimation of the serum TSH level appeared to correlate with more advanced disease and with the earliest evidence of failure of thyroid function.It is suggested that serum TSH measurements are clinically helpful in patients with positive thyroid antibody testes and in patients with low or low normal proteinbound iodine levels.