triiodothyronine--reverse and Crohn-Disease

Forty patients with ulcerative colitis and Crohn's disease were divided into four groups. They were given betamethasone (6 mg daily) either iv or orally in combination with either iv or oral administration of nutrients. The glucocorticoid reduced the serum T4 significantly (11-16%) when the nutrition was given iv and the same trend occurred (7-9%) in the orally nutriated groups. Corticosteroids reduced the serum T3 by 20-39%, TSH 29-67%, delta TSH 45-76% and TBG 11-18% and increased the rT3 by 19-66% and the T3-uptake 6-16% irrespective of the mode of administration of the steroids although the changes did not reach statistical significance (P less than 0.05) in all groups. A significant increase of serum TBPA by 24% occurred only in the group receiving both steroids and nutrition iv with only minor or no changes (0-12%) in the other three groups. Except for the serum T4 the results were not influenced by the mode of nutrition (iv or oral).

Topics: Adult; Betamethasone; Colitis, Ulcerative; Crohn Disease; Female; Humans; Male; Middle Aged; Parenteral Nutrition; Thyroid Hormones; Thyrotropin; Thyroxine; Thyroxine-Binding Proteins; Triiodothyronine; Triiodothyronine, Reverse

Topics: Adolescent; Adult; Aged; Celiac Disease; Crohn Disease; Humans; Male; Middle Aged; Thyroid Gland; Thyroid Hormones; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Thyroxine-Binding Proteins; Triiodothyronine; Triiodothyronine, Reverse

To evaluate the possible alterations in thyroxine metabolism in patients with Crohn's disease (C.D.), the serum concentrations of thyroxine (T4), triiodothyronine (T3), 3,3',5'-triiodothyronine (rT3), and thyroxine binding globulin (TBG) were determined in 23 patients with C.D. and in 25 healthy controls. While concentrations of T4 and rT3 in patients with C.D. were similar to those seen in healthy controls, serum T3 was lower in patients with C.D. (0.93 +/- 0.4 ng/ml) than in controls (1.20 +/- 0.3 ng/ml, p less than 0.005). TBG concentrations were elevated in two patients with C.D., and below normal in two others. However, the group mean of TBG concentrations in patients with C.D. (23.7 +/- 6.9 micrograms/ml) was similar to that of healthy controls (21.9 +/- 3.6 micrograms/ml, p greater than 0.05). Changes in peripheral deiodination of thyroxine, enhanced in some cases by treatment with glucocorticoids and/or increased turnover of T3 may be the cause of the decreased concentration of T3 in some patients with Crohn's disease.

Topics: Adolescent; Adult; Aged; Colitis; Crohn Disease; Female; Humans; Ileitis; Male; Middle Aged; Proctitis; Serum Globulins; Thyroxine; Thyroxine-Binding Proteins; Triiodothyronine; Triiodothyronine, Reverse