The Effect of Hepatic Enzyme-Inducing Drugs on Thyroid Hormones and the Thyroid Gland*

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Abstract
Introduction THE metabolism of thyroid hormone occurs through a variety of pathways, the most important ones being deiodination and conjugation with glucuronates and sulfates. As much of this metabolic activity occurs in the liver, it is important to consider the effect on thyroid hormone metabolism of drugs or industrial prod- ucts that affect hepatic enzyme systems. There are a number of compounds that have been found to increase thyroid hormone excretion via this mechanism, primarily through enhanced glucuronidation. An intact hypothalamic- pituitary-thyroid axis can compensate for increased peripheral metabolism of thyroid hormone by way of increasing the thyroid gland's hormone production. However, consideration must be given to the effects of long term stimulation of the thyroid gland as animal studies have implicated chronic thyroid stimulation as a cause of neoplastic changes in the gland. In this paper, the available data regarding this consideration are reviewed. I. Metabolism of Thyroid Hormone Metabolism of thyroid hormones occurs through a variety of pathways in different organs before eventual excretion of metabolites through the biliary system and feces or via the kidneys.

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