Drugs that suppress TSH or cause central hypothyroidism.

Drugs that suppress TSH or cause central hypothyroidism.
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DOI:
10.1016/j.beem.2009.08.003
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发表时间:
2009-12
期刊:
Best practice & research. Clinical endocrinology & metabolism
影响因子:
--
通讯作者:
Haugen BR
Haugen BR
中科院分区:
其他
文献类型:
--
作者:
Haugen BR

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许多不同的药物会影响甲状腺功能。这些药物中的大多数作用于甲状腺功能正常的患者的甲状腺水平,或作用于需要外源性左旋甲状腺素的患者的甲状腺激素吸收或代谢水平。包括糖皮质激素、多巴胺激动剂、生长抑素类似物和类生长激素在内的一小部分药物通过抑制促甲状腺激素或下丘脑中的TSH来影响甲状腺功能。幸运的是,这些药物中的大多数不会引起临床上明显的中枢性甲状腺功能减退症。一类新的核激素受体激动剂,称为rexinoids,在大多数患者中引起临床显著的中枢性甲状腺功能减退症,多巴胺激动剂可能会加重非甲状腺疾病患者的“甲状腺功能减退症”。在这篇综述中,我们探讨了这些药物抑制TSH的机制和这些作用的临床意义。
Many different drugs affect thyroid function. Most of these drugs act at the level of the thyroid in patients with normal thyroid function, or at the level of thyroid hormone absorption or metabolism in patients requiring exogenous levothyroxine. A small subset of medications including glucocorticoids, dopamine agonists, somatostatin analogs and rexinoids affect thyroid function through suppression of TSH in the thyrotrope or hypothalamus. Fortunately, most of these medications do not cause clinically evident central hypothyroidism. A newer class of nuclear hormone receptors agonists, called rexinoids, cause clinically significant central hypothyroidism in most patients and dopamine agonists may exacerbate ‘hypothyroidism’ in patients with nonthyroidal illness. In this review, we explore mechanisms governing TSH suppression of these drugs and the clinical relevance of these effects.
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