HYPOTHYROIDISM IN CHILDHOOD. II. SENSITIVITY TO THYROID MEDICATION AS MEASURED BY THE SERUM CHOLESTEROL AND THE CREATINE EXCRETION1

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Abstract
The detn. of the serum cholesterol and of the creatine excretion was used to measure the sensitivity of response to thyroid in hypo-thyroid and in normal children. The study of the response to small daily oral doses of thyroid or to a single inj. of thyroxin showed that the effect upon the serum cholesterol served better to differentiate the hypothyroid from the normal child than did the increase in creatinuria. With a daily dose of 2 grains (128 mg.) of desiccated thyroid, the serum cholesterol of hypothyroid patients decreased 117 to 385 mg.% and, with a single dose of 2 mg. or 5 mg. of thyroxin, 120 to 229 mg.%. The decrease in normal children was 0 to 76 mg.%, which was within the range of spontaneous fluctuations. With a single dose of thyroxin, the effect lasted an avg. of 38 days in hypothyroid children, and 9 days in normal children. In hypothyroid children, daily doses of thyroid as small as 1/2 grain (32 mg.) uniformly caused an increase in the creatine excretion. This same dose caused increased creatinuria in 42.8% of normal children, and 2 grains (128 mg.) daily caused an increase in 77.3%. Therefore, creatinuria is a more delicate indicator of thyroid effect in normal children than is cholesterolemia. Normal children may have differences in their sensitivity to thyroid. However, other possible interpretations are discussed. 9 dwarfs who showed no evidence of hypothyroidism showed cholesterol and creatine response to thyroid identical with those of normal children. There were no differences between dwarfs with retarded osseous development and those with normal development.

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