The Achilles Reflex in Thyroid Disorders

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Abstract
The speed of the Achilles reflex was recorded and measured utilizing a commercial electromagnetic device in 60 normal males, 64 normal females, 71 hospitalized patients with a variety of Illnesses but without thyroid disease, and in 21 patients with thyroid disease but who were clinically euthyroid. The Achilles reflex speed was also measured in 20 thyrotoxic patients and in 15 hypothyroid patients. Three different parts of the reflex were measured and correlated with thyroid function. All measurements were quite accurate in differentiating hypothyroid patients from the control group. However, the interval including the last part of the contraction and 1st part of the relaxation phase (V-P interval) proved to be far superior to other measurements in separating hyperthyroid patients from normals. Considerable improvement was obtained by taking a mean of several reflex complexes and by including tracings from both ankles. The results compared favorably with the PBI and 24-hr. I131 uptake. Normal range for this interval was 155-265 milliseconds (males). In hyperthyroidism the range was 100-150 milliseconds. In hypothyrolds 285-780 milliseconds. Normal females had a significantly slower reflex time than males. A fast reflex was noted in a patient with myotonia dys-trophica. A slow reflex was noted in 4 of 7 patients with pernicious anemia. Aspirin, epinephrine and dextroamphetamine had no effect on the reflex speed. The effects of cold and heat were also studied. Several other aspects of reflex changes in thyroid disease are discussed.

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