propylthiouracil and Weight-Loss

Hyperthyroidism is a common metabolic disorder, although its presentation as an endocrine emergency called thyroid storm is rare. Here we review a case of a thyroid storm as the initial presentation of thyrotoxicosis, with multiple organ failure and haemodynamic collapse due to low-output cardiac dysfunction. Quick intervention with aggressive antithyroid therapy, including steroid pulse, and supportive intensive care measures led to an outstanding improvement and full recovery. The present case clearly shows the beneficial impact of initial clinical suspicion resulting in an early diagnosis and intensive therapy. Moreover, it supports the additional role of steroids to aggressive antithyroid strategy in order to control associated deleterious systemic inflammatory reactions.

Topics: Anticholesteremic Agents; Antithyroid Agents; Cholestyramine Resin; Critical Care; Heart Rate; Hemodynamics; Humans; Iodides; Male; Middle Aged; Multiple Organ Failure; Propylthiouracil; Shock, Cardiogenic; Steroids; Thyroid Crisis; Treatment Outcome; Ventricular Dysfunction, Left; Weight Loss

Taste blindness to 6-n-propylthiouracil (PROP) associates with increased fat preference and intake. No studies have matched a diet to a woman's PROP phenotype to improve weight loss. This study investigated (1) whether PROP nontaster (NT) women would lose more weight following a low-carbohydrate (LC) diet than a low-fat (LF) diet, and (2) whether PROP supertaster (ST) women would lose more weight following a LF diet than a LC diet.. One hundred seven women (BMI = 34.8 ± 0.5 kg/m. At 6 months, NTs lost more weight following the LC than the LF diet (-8.5 ± 0.5 kg vs. -6.6 ± 0.5 kg, P = 0.008); there was no difference between STs following either diet (-8.8 ± 0.4 vs. -8.9 ± 0.5, P = 0.35). Dietary self-reports were unrelated to weight loss, and prescription of a LC diet associated with greater self-efficacy.. NT women lost more weight following the LC diet compared to the LF diet. Screening for PROP phenotype may help personalize diet therapy for NT women to optimize their short-term weight loss.

Topics: Adolescent; Adult; Diet, Carbohydrate-Restricted; Diet, Fat-Restricted; Female; Humans; Middle Aged; Propylthiouracil; Weight Loss; Young Adult

Changes in perceived intensity and liking of tasted foods have not been studied during weight loss from dieting. These outcomes were examined during a 6-month lifestyle intervention in women who had been classified by sensitivity to the bitter taste marker, 6-n-propylthiouracil (PROP), and then randomized to a low-fat or low-carbohydrate diet.. Sixty-nine women (BMI = 34.4 kg/m(2) ; age = 44.2 years) followed the low-fat diet (n = 31) or low-carbohydrate diet (n = 38). At baseline and at 3, and 6 months, they rated overall liking and intensity of attributes in strawberry milk and salad dressing varying in sucrose (0%, 15%, and 30% wt/vol) or fat (10%, 30%, 50% wt/vol) content, respectively.. Perceived intensity of the attributes did not change. For all participants, the 15% and 30% sucrose milk samples were equally liked at baseline and 3 months, but by 6 months, the 15% sucrose sample was highest liked (P < 0.007). Also, the 50% fat sample was most liked at baseline and least liked by 6 months (P = 0.04), and this effect was most pronounced in the nontasters (P < 0.02). There were no effects of diet prescription on liking.. Weight loss from dieting resulted in a hedonic shift for foods with lower sucrose and fat content.

Topics: Adult; Animals; Biomarkers; Diet, Carbohydrate-Restricted; Diet, Fat-Restricted; Dietary Fats; Dietary Sucrose; Feeding Behavior; Female; Food Preferences; Humans; Middle Aged; Milk; Propylthiouracil; Sucrose; Taste; Taste Perception; Weight Loss

Hyperthyroidism is rare in early childhood and most commonly caused by Graves' disease. We report 14 children (4 boys, 10 girls) aged 3.4-7.5 yr. At diagnosis, all patients had weight loss, hyperkinetic activity, tachycardia, difficulty sleeping, and poor concentration and 11 presented with proptosis. Four patients developed long-term neuropsychological problems. There was a family history in 7 cases. All patients had goiters, clinically assessed to be large and diffuse in 21%, medium-sized in 43%, and small in 36%. At diagnosis, height was increased with median (range) height; 1.25 standard deviation score (SDS) (-0.2-5.24) and body mass index (BMI) was decreased; -0.48 SDS (-1.65-1.26). Height and BMI SDS values were statistically different (p<0.032) Bone age was advanced in 4 of 5 children, who had assessments. Total or free T4 levels were elevated and TSH was undetectable. Ninety percent of patients (12/14) had positive thyroid peroxidase autoantibodies, mean level 680 IU/ml (range 50-1347). Initial treatment was with antithyroid medication using carbimazole; median dose 0.75 mg/kg/day (no.=13) or propylthiouracyl 15 mg/kg/day (no.=1). T4 was added in 6 patients. Normalisation of serum T4 occurred at 4 months (1- 9) and TSH at 7 months (3-24) after start of therapy. Treatment was discontinued after a minimum of 2 yr in 11 patients, relapse occurring in 9. Median duration of total therapy was 58 months (18-132). During adolescence, 4 patients had curative therapy by surgery (no.=2) or radioiodine (no.=2). In conclusion, disturbance of growth, behavioral difficulties and infrequent spontaneous remission are key features of Graves' disease in early childhood.

Topics: Age of Onset; Antithyroid Agents; Attention Deficit Disorder with Hyperactivity; Carbimazole; Child; Child, Preschool; Exophthalmos; Female; Graves Disease; Growth Disorders; Humans; Hyperkinesis; Iodide Peroxidase; Male; Propylthiouracil; Recurrence; Retrospective Studies; Sleep Wake Disorders; Tachycardia; Thyrotropin; Thyroxine; Weight Loss

Topics: Adult; Anti-Arrhythmia Agents; Antithyroid Agents; Anxiety; Arrhythmias, Cardiac; Dyspnea; Graves Disease; Humans; Hypokalemic Periodic Paralysis; Malaysia; Male; Methimazole; Muscle Weakness; Neurologic Examination; Potassium; Propranolol; Propylthiouracil; Sleep Initiation and Maintenance Disorders; Tremor; Weight Loss

A 32-year-old woman presented with persistent vomiting, epigastric pain and weight loss. A sinus tachycardia was the clue to the diagnosis of hyperthyroidism due to Graves' disease. On treatment with propylthiouracil and a beta-blocking agent, her symptoms resolved within one day, even though her free thyroxine level was still high. Hyperthyroidism is an uncommon, but previously reported cause of persistent vomiting.

Topics: Abdominal Pain; Adrenergic beta-Antagonists; Adult; Chronic Disease; Diagnosis, Differential; Female; Humans; Hyperthyroidism; Metoprolol; Propylthiouracil; Thyrotoxicosis; Vomiting; Weight Loss