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Psychosomatic Medicine, Vol 50, Issue 6 600-606, Copyright © 1988 by American Psychosomatic Society

ORIGINAL ARTICLES

Anorexia nervosa with elevated serum TSH

S Matsubayashi, H Tamai, S Uehata, N Kobayashi, K Mori, T Nakagawa and LF Kumagai
Department of Psychosomatic Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

Low or normal serum TSH concentration is common during fasting and in patients with anorexia nervosa. We report here four patients with anorexia nervosa who had elevated serum TSH, low T3 and low free T4 levels when the initial diagnosis was made. Also, an appearance of TSH peak in response to TRH was delayed, but T3 responsiveness to TRH was normal. All patients were clinically euthyroid with negative serum thyroid autoantibodies and without goiter. Following weight gain, basal levels of serum T3, free T4, and TSH, as well as TSH responsiveness to TRH, returned almost to normal. The data indicated that these patients with anorexia nervosa before refeeding had either a latent transient primary hypothyroidism or the low T3 syndrome associated with an inappropriately high secretion of TSH, probably a new condition that is related to their pretreatment nutritional state.




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Copyright © 1988 by the American Psychosomatic Society