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Influence of Thyroid Status on Dopaminergic Inhibition of Thyrotropin and Prolactin Secretion: Evidence for an Additional Feedback Mechanism in the Control of Thyroid Hormone Secretion

Endocrine Unit, Department of Medicine, and Immunoassay Section of the Department of Clinical Chemistry, Royal Infirmary Edinburgh, United Kingdom

Address all correspondence and requests for reprints to: Dr. A. D. Toft, Department of Medicine, Royal Infirmary, Edinburgh EH3 9YW, United Kingdom.

Serum TSH and PRL concentrations were measured after the randomized oral administration of either metoclopramide, L-dopa, or placebo on 3 consecutive days to fivepatients with overt primary hypothyroidism (low serum total T₄ and raised serum TSH) and to five patients with subclinical hypothyroidism (normal serum total T₄ and raised serum TSH). In both groups there was a rise in serum TSH and PRL concentrations after metoclopramide and a fall after L-dopa when compared with the effect of the placebo. However, the rise in serum TSH and PRL concentrations was significantly greater in patients with subclinical hypothyroidism compared to that in patients with overt hypothyroidism. It was not possible to show any significant difference in the degree of fall of these pituitary hormones after L-dopa administration in the two groups.

These results suggest that in addition to the established negative feedback of thyroid hormones at the level of anterior pituitary thyrotropes, there is a previously unrecognized effect of thyroid hormones at the hypothalamus, resulting in increased dopaminergic inhibition of TSH release. Stimulation of hypothalamic dopamine by thyroid hormones also inhibits PRL secretion.

^* Present address: Department of Medicine, Western General Hospital, Edinburgh EH4 2XU, United Kingdom.

Received February 5, 1980.

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