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Oral Cholecystographic Agents and the Thyroid

Division of Endocrinology and Metabolism (M.B., D.S.C.), Sinai Hospital, Baltimore, Maryland 21215; Serviço de Endocrinologia e Metabologia do Paraná (M.B.), Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil 80.060-240; Johns Hopkins University School of Medicine (D.S.C.), Baltimore, Maryland 21215

Address all correspondence and requests for reprints to: David S. Cooper, M.D., Division of Endocrinology, Sinai Hospital of Baltimore, Baltimore, Maryland 21215. E-mail: dcooper{at}lifebridgehealth.org

Oral cholecystographic agents (OCAs) are known to affect thyroid hormone metabolism by acting as potent inhibitors of type I and type II deiodinases, blocking the conversion of T₄ to T₃ and rT₃ to T₂. In addition, iodine released from the drug blocks thyroid gland secretion of thyroid hormone. These properties make OCAs a potentially useful drug therapy in patients with hyperthyroidism and other thyrotoxic disorders. Short-term treatment with OCAs rapidly reduces serum T₃ levels, with a lesser effect on T₄ levels. OCAs are not useful for long-term treatment, which is usually followed by exacerbation of hyperthyroidism with continued use. The lack of significant side effects makes these drugs an excellent short-term option in situations where a rapid clinical improvement is critical.

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