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Prolonged Dopamine Administration and Thyroid Hormone Economy in Normal and Critically 111 Subject^*

ELAINE M. KAPTEIN, CAROLE A. SPENCER, MICHAEL B. KAMIEL and JOHN T. NICOLOFF

Division of Endocrinology, Department of Medicine, University of Southern California School of Medicine, Los Angeles, California 90033

Address requests for reprints to: Elaine M. Kaptein, M.D., University of Southern California School of Medicine, Department of Medicine, Division of Endocrinology, 2025 Zonal Avenue, Los Angeles, California 90033.

A 48-h dopamine (DA) infusion (5–7.5 fig/kgmin) given to six healthy euthyroid males resulted in a suppression of thyroidal iodine release and serum TSH by 44 % 3% (P < 0.01), serum T₃ by 9 ± 2± (P < 0.01), and serum T₄ by 5 ± 1% (P < 0.05) below baseline levels, without a significant change in serum rT₃ levels. In critically ill patients receiving DA (2–21 ±ig/ kg-min) for treatment of shock, serum TSH values and T.(production rates were decreased 60± and 56%, respectively, below the respective levels observed in non-DA-treated patients (P < 0.01). Serial serum samples collected before and during DA therapy revealed a decrease of 52% in TSH (P < 0.005) and 30% in T₄ (P < 0.05). The finding of a normal serum TSH value during DA therapy in a critically ill patient with primary hypothyroidism emphasized the inhibitory potential of DA on TSH secretion. These findings indicate that the prolonged administration of pharmacological doses of DA significantly reduced serum TSH levels and thyroid hormone secretion in normal and critically ill patients, most likely by a direct inhibition of pituitary TSH with a secondary effect on thyroid gland secretion. Therefore, DA therapy probably prolongs and aggravates the low T₄ state in critical illness.

^* This work was supported in part by NIH Grant AM-11727 and General Clinical Research Center Grant RR-43. Presented in part at the Western Society for Clinical Research, February 1978 and at the 60th Annual Meeting of The Endocrine Society, Miami, FL, 1978.

Recipient of a Medical Research Council of Canada Fellowship.

Received February 4, 1980.

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