triiodothyronine--reverse and Depressive-Disorder

Topics: Adolescent; Adult; Aged; Arousal; Depressive Disorder; Female; Humans; Male; Middle Aged; Prognosis; Schizophrenia; Thyroid Hormones; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

Topics: Adult; Antidepressive Agents, Tricyclic; Depressive Disorder; Female; Humans; Male; Middle Aged; Thyrotropin; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

Serum concentrations of thyrotropine (TSH), thyroxine (T4), free T4 (fT4), triiodothyronine (T3) and reverse T3 (rT3) were measured 4 x during a 12-month period in 28 patients with major depressive disorder maintained on lithium prophylaxis for 4-23 years (mean = 11.8). The course of illness was carefully monitored and documented for all patients throughout a 3.5-year period. All hormones were also measured in 41 healthy controls matched for age and gender. Patients on lithium had normal serum concentrations of TSH, T4, fT4 and T3 only the levels of rT3 were elevated. The efficacy of the lithium prophylaxis was significantly correlated to the serum concentrations of T3, i.e., the higher the patients' serum levels of T3, the shorter was the overall duration of recurrences of depression within the 3.5-year period. We conclude that: (1) thyrotropine and the thyroid hormones, which are often abnormal during the first weeks or months of lithium treatment, returned to normal when lithium prophylaxis was maintained for years; (2) a possible explanation for the higher T3-serum concentrations in responders might be that lithium interacts with thyroid hormone metabolism in the CNS, leading to enhanced T3 concentrations in the tissue and to a secondary increase in the serum concentrations of T3.

Topics: Adult; Aged; Aged, 80 and over; Bipolar Disorder; Depressive Disorder; Female; Humans; Hypothalamo-Hypophyseal System; Lithium Carbonate; Long-Term Care; Male; Middle Aged; Pituitary-Adrenal System; Psychiatric Status Rating Scales; Psychotic Disorders; Recurrence; Thyroid Function Tests; Thyrotropin; Thyroxine; Treatment Outcome; Triiodothyronine; Triiodothyronine, Reverse

Free thyroxine index (FT4I), serum thyroxine (T4) and thyrotrophin concentrations were measured in 45 depressed subjects and 23 controls. The FT4I am/pm ratio was significantly higher in depressed subjects than in controls. This elevated diurnal ratio of thyroid hormones in depression adds to the literature on the chronobiology of affective disorders, and may help to explain differences in thyroid hormone levels in depressed patients in other studies, where time of sampling has seldom been reported.

Topics: Adolescent; Adult; Bipolar Disorder; Circadian Rhythm; Depressive Disorder; Female; Humans; Male; Middle Aged; Thyroid Hormones; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

Total and free concentrations of T4 and rT3 in serum and cerebrospinal fluid were estimated by ultrafiltration in 12 patients with unipolar endogenous depression before and after electroconvulsive treatment. Recovery from depression resulted in a decrease in CSF concentrations of free T4 (median) (26.2 to 21.4 pmol/l, p less than 0.02) and free rT3 (14.1 to 12.3 pmol/l, p less than 0.05). Concentrations of free T4 in the cerebrospinal fluid were lower than those in serum (p less than 0.02), the ratio being 0.6. In contrast, levels of free rT3 in the cerebrospinal fluid were considerably higher than those found in serum (p less than 0.01), the ratio being 25. These ratios did not change following recovery from depression. In 9 patients with nonthyroidal somatic illness, concentrations of free T4 and rT3 in the cerebrospinal fluid were similar to those found in patients with endogenous depression, whereas 4 hypothyroid patients and one hyperthyroid patient had considerably lower and higher, respectively, concentrations of both free T4 and rT3. In conclusion, levels of free T4 and free rT3 in the cerebrospinal fluid are increased during depression compared with levels after recovery, probably reflecting an increased supply of T4 from serum and an increased production of rT3 from T4 in the brain. The data also suggest that the transport of iodothyronines between serum and the cerebrospinal fluid is restricted.

Topics: Aged; Depressive Disorder; Electroconvulsive Therapy; Female; Humans; Hyperthyroidism; Hypothyroidism; Male; Middle Aged; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

This study investigated the effects of dexamethasone (1 mg orally) on the function of the hypothalamic-pituitary-thyroid (HPT) axis. We determined pre- and post-dexamethasone thyroid-secreting hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), reverse T3 and cortisol levels in 61 depressed inpatients. Dexamethasone had a pronounced suppressive effect on basal TSH and FT3 levels. It had a significant stimulating effect on rT3 levels. No differences were found between melancholic and minor depressives in the effects of dexamethasone on basal TSH, FT3 and rT3. Cortisol non-suppressors were characterized by less suppression of basal TSH values.

Topics: Depressive Disorder; Dexamethasone; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Thyroid Gland; Thyroid Hormones; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

Chronic alcoholics who had been abstinent from alcohol for more than 2 years were evaluated with the thyrotropin-releasing hormone (TRH) test. The findings suggest the following profound disturbances in the hypothalamic-pituitary-thyroid axis: 1) a "euthyroid sick syndrome," evidenced by low levels of triiodothyronine (T3), high levels of reverse T3, and normal levels of thyroxine (T4) (this syndrome implies a decreased 5'-deiodination of T4 to T3 and of reverse T3 to its lesser iodinated metabolites), 2) an increased binding capacity for thyroid hormones, evidenced by a decreased T3-uptake value and an increased level of T4-binding globulin, and 3) thyroid-stimulating hormone (TSH) blunting in 31% of patients. Paradoxically, there was a positive correlation between basal T4 and delta max TSH in subjects with blunted TSH, but baseline TSH levels were reduced in subjects with and without blunted TSH.

Topics: Adult; Aged; Alcohol Drinking; Alcoholism; Depressive Disorder; Growth Hormone; Humans; Male; Middle Aged; Prolactin; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse

Serum levels of 3,3',5' triidothyronine (reverse T3) were investigated in 32 patients with acute major depressive disorder. Twenty-six of these patients were also studied during a state of clinical improvement. Comparison subjects were 22 healthy controls, and 16 currently euthymic patients with histories of affective disorders (8 unipolar, 8 bipolar). The laboratory investigation included the determination of triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and thyroxin-binding globuline (TBG) levels in serum. The clinical symptoms were rated by the Comprehensive Psychopathological Rating Scale (CPRS) for depressive illness (CPRS global score), as well as the sum of 10 items (CPRS 10) and 22 items (CPRS 22) measuring depression. The patients were also divided into those having a normal or abnormal response to the dexamethasone suppression test; those having melancholia or not having melancholia; and those having primary or secondary depression. No significant difference in reverse T3 levels emerged among the patients with acute major depressive disorders, the euthymic unipolar or bipolar affective disorders, and the healthy controls. There were also no significant differences between those having an abnormal or normal DST test; those having primary or secondary depression; or those having melancholia or not having melancholia. In the group of patients with acute major depressive disorder, however, a significant increase in reverse T3 levels and a significant decrease in T3 levels, but no significant difference in T4 or TSH levels, were seen in the patients with the most pronounced clinical symptoms as measured by the CPRS. The implications of these findings are discussed.

Topics: Adult; Bipolar Disorder; Depressive Disorder; Dexamethasone; Female; Humans; Hydrocortisone; Male; Middle Aged; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Thyroxine-Binding Proteins; Triiodothyronine; Triiodothyronine, Reverse

A relatively high percentage of patients with affective disorders have abnormalities of thyroid function, and over 60% of endogenously depressed and most manic patients show a blunted thyroid-stimulating hormone (TSH) response to thyroid-releasing hormone (TRH) injections. We now replicate earlier findings concerning relatively high 3,3',5'-triiodothyronine (reverse T3) levels in unipolar depressives and find similarly high levels in manic women. The significance of the present finding is unknown, but measurement of reverse T3 levels as a potential tool in differential diagnosis of affective disorders and in psychobiological research should be explored further.

Topics: Adult; Affective Disorders, Psychotic; Bipolar Disorder; Depressive Disorder; Female; Humans; Thyroxine; Triiodothyronine; Triiodothyronine, Reverse