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Suppression of Endogenous TSH: A New Treatment of Subacute Thyroiditis¹

The Department of Medicine, University of Toronto, and the Medical Service, St. Michael's Hospital Toronto, Canada

Thirty-two cases of subacute thyroiditis (painful, nonsuppurative swelling of the thyroid gland, excluding hemorrhage into adenomas) were treated with 100 µg Ltriiodothyronine (T3) per day. Twenty of these cases had a complete response to T3, 2 had an incomplete response and 10 had no response. The 12 cases with incomplete or no response to T3 were treated with prednisone. Nine had a complete response to prednisone.

An illustrative case will be presented who relapsed following withdrawal of T3 on 3 occasions and improved rapidly on reinstitution of therapy. A fourth relapse was precipitated by the concomitant administration of TSH. Three other patients who were given TSH had exacerbation of their disease. These observations suggest that endogenous TSH is implicated in the etiology of some cases of subacute thyroiditis and that its suppression is beneficial.

This study was supported by grants from the Ontario Cancer Treatment and Research Foundation.

¹ Part of this material was presented as read to the 44th Meeting of the Endocrine Society, Chicago, Illinois, June 21–23, 1962.

Received October 2, 1962.