Standardisierung des TRH-Tests zur Feineinstellung einer Thyroxin-Behandlung

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Abstract
A TRH [thyroliberin] test was performed on 50 patients treated with daily thyroxine [T4] dose of 50-200 .mu.g. Results were compared with a test performed at the earliest 3 wk before with the same T4 dosage, but the latter having been interrupted for 24 h. In the 1st case T4 was 8.96 .+-. 2.9 .mu.g/dl, in the 2nd 7.08 .+-. 2.0 .mu.g/dl; T3 in the 1st case 1.28 .+-. 0.3 ng/ml, in the 2nd 1.03 .+-. 0.25 ng/ml. This indicates that with both thyroid hormones the levels were higher on the day of administration than 24 h later. Correspondingly, TRH-stimulated TSH thyrotropin secretion was definitely lower on the day of treatment. .DELTA.TSH (TSH after 30 min minus TSH zero value) was 16.1 .+-. 26.5 on day of treatment, 27.3 .+-. 35.6 .mu.U/ml after pause. Accordingly, to achieve fine tuning of T4 treatment, such as for euthryoid goiter, the TRH tests standardized on 200 .mu.g TRH should be performed after a T4-free 24 h interval. .DELTA.TSH should then not be more than double the initial TSH level. Using such dosage regimen, drug-induced hyperthyroidism can be definitely avoided.