Dynamics of serum thyrotropin and thyroid hormone changes in fasting

Spencer, Carole A.; Lum, Steven M. C.; Wilber, John F.; Kaptein, Elaine M.; Nicoloff, John T.

doi:10.1210/jcem-56-5-883

Cited by 111Thyroid Disorders and TreatmentsGrowth Hormone and Insulin-like Growth FactorsRegulation of Appetite and Obesity

Dynamics of serum thyrotropin and thyroid hormone changes in fasting

Spencer, Carole A., Lum, Steven M. C., Wilber, John F., Kaptein, Elaine M., Nicoloff, John T.·1983·The Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jcem-56-5-883

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Abstract

This study was designed to address the question of whether decreased hypothalamic TRH secretion was responsible for the transient decline in serum TSH levels characteristic of the early phase of fasting in man. Changes in serum TSH, total T4 (TT4), free T4 (FT4), and total T3 (TT3)/TT4 and total rT3(TrT3)/TT4 ratio values together with plasma TRH levels were evaluated before, during, and after a constant 48-h infusion of either TRH (75 ng/min), or saline, initiated at 10 h into a 6-day fast, in groups of six ambulating, mildly obese female subjects. On the first day of the fast, no change in serum TSH levels was seen with saline infusion relative to control, whereas mean TSH levels rose 2 1/2-fold with TRH infusion. On the second day of the fast, serum TSH levels simultaneously declined in both the saline- (43%, P less than 0.005) and TRH- (52%, P less than 0.005)-infused groups relative to the previous day. On the third day of the fast, after stopping the infusions, mean serum TSH levels fell below control in both the saline- and TRH-treated groups, but subsequently returned to prefasting levels. A distinct circadian pattern of TSH release was present throughout the study. Plasma TRH values were unaffected by fasting in the saline-infused group, but rose 2 1/2-fold in the TRH-infused group. The sequence of changes in the serum thyroid hormone indices were similar for the two groups: a rapid rise in FT4 was followed by a gradual fall in TT3/TT4 ratios during the first 24 h of fast, which was followed by a rise in TrT3/TT4 ratios after 48 h of fast. This study in fasting, mildly obese females suggests that: 1) The transient suppression of serum TSH during early fasting is not TRH mediated. 2) Fasting does not alter plasma TRH levels. 3) A temporal sequence of changes in serum thyroid hormone indices occurs in fasting, this being an initial rise in FT4 (10 h) followed by a fall in both serum TT3/TT4 (12-14 h) and TSH (30-36 h) and finally by a rise in TrT3/TT4 levels (48 h). This sequence of events suggests that the initial inhibition of serum TSH levels in early fasting results from the acute elevation in FT4 levels, and that the reestablishment of normal serum TSH levels with continued fasting is associated with declining serum TT3 levels.

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A complex sequence of alterations in serum TSH and thyroid hormone levels has been observed in humans undergoing a short-term fast.
“A complex sequence of alterations in serum TSH and thyroid hormone levels has been observed in humans undergoing a short-term fast (37, 38).”
From The role of falling leptin levels in the neuroendocrine and metabolic adaptation to short-term starvation in healthy men (2003) · cites this paper as [37]
Free T4 levels may be transiently increased or normal, while TSH levels may be normal or decreased during fasting or caloric deprivation.
“Free T4 levels may be transiently increased or normal, while TSH levels may be normal or decreased (12, 13).”
From Can Reverse T3 Assay Be Employed to Guide T4 vs. T4/T3 Therapy in Hypothyroidism? (2019) · cites this paper as [12]
A simultaneous increase in rT3 occurs in the first 2 weeks after caloric restriction, followed by normalization.
“A simultaneous increase in rT3 occurs in the first 2 weeks after caloric restriction, followed by normalization.”
From Can Reverse T3 Assay Be Employed to Guide T4 vs. T4/T3 Therapy in Hypothyroidism? (2019) · cites this paper as [12]
During fasting or relative caloric deprivation, serum T3 is decreased as a homeostatic response to conserve energy and protein.
“During fasting or relative caloric deprivation, for instance, serum T3 is decreased as a homeostatic response to conserve energy and protein.”
From Can Reverse T3 Assay Be Employed to Guide T4 vs. T4/T3 Therapy in Hypothyroidism? (2019) · cites this paper as [12]

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Authors: Spencer, C. A., Lum, S. M. C., Wilber, J. F., Kaptein, E. M., & Nicoloff, J. T.
Affiliations: University of Southern California (US)
ORCID: Spencer, Carole A.
Kaptein, Elaine M.
Venue: The Journal of Clinical Endocrinology & Metabolism
Publisher: The Endocrine Society
Published: 1983-05
Volume: 56
Issue: 5
Pages: 883-888
ISSN: 0021-972X (ISSN-L)
1945-7197
DOI: 10.1210/jcem-56-5-883
OpenAlex: W2081853649
Cited by: 111
References: 31
Citations by year: 2024: 1 · 2023: 5 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 4 · 2018: 4 · 2017: 2 · 2016: 3 · 2015: 1 · 2014: 3 · 2013: 3 · 2012: 2
FWCI: 4.10
Type: journal article
Language: en
Open access: closed
Locations: The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
Keywords: fasting, thyroid-stimulating hormone, thyrotropin-releasing hormone, thyroid hormones, free thyroxine, triiodothyronine, reverse T3, hypothalamic-pituitary-thyroid axis, circadian rhythm, obesity, women
MeSH terms: Adult, Circadian Rhythm, Fasting, Female, Humans, Kinetics, Middle Aged, Thyroid Hormones, Thyrotropin, Thyrotropin-Releasing Hormone, Thyroxine, Triiodothyronine, Triiodothyronine, Reverse

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Dynamics of serum thyrotropin and thyroid hormone changes in fasting

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