Thyroxine Replacement Requirements in Hypothyroid Patients Receiving Phenytoin
Authors: JOSEPH L. BLACKSHEAR
Journal: Annals of Internal Medicine (1983)

Brief Reports1 September 1983Thyroxine Replacement Requirements in Hypothyroid Patients Receiving PhenytoinJOSEPH L. BLACKSHEAR, M.D., ALVIN L. SCHULTZ, M.D., JEROLD S. NAPIER, M.D., DAVID D. STUART, M.D.JOSEPH L. BLACKSHEAR, M.D.Search for more papers by this author, ALVIN L. SCHULTZ, M.D.Search for more papers by this author, JEROLD S. NAPIER, M.D.Search for more papers by this author, DAVID D. STUART, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-99-3-341 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPatients receiving phenytoin have lower levels of serum thyroxine (T4), free T4, triiodothyronine (T3), free T3, and reverse T3 than controls. Values for serum thyrotropin (TSH) are normal, however, and these patients remain clinically euthyroid (1-6). We report a patient with primary hypothyroidism on long-term thyroxine replacement who developed clinical hypothroidism after starting phenytoin.A 32-year-old woman consulted her physician in February 1982 because of cold intolerance and hypersomnolence. At age 13 she had been started on phenytoin for seizures; the drug was discontinued at age 23 after 10 years without a seizure. At age 28 she developed fatigue 2...References1. OPPENHEIMERFISHERNELSONJAILER JLKJ. Depression of the serum protein-bound iodine level by diphenylhydantoin. J Clin Endocrinol Metab. 1961;21:252-62. CrossrefMedlineGoogle Scholar2. LIEWENDAHLMAJURIHELENIUS KHT. Thyroid function tests in patients on long-term treatment with various anticonvulsant drugs. Clin Endocrinol. 1978;8:185-91. CrossrefMedlineGoogle Scholar3. FINUCANEGRIFFITHS JR. Effect of phenytoin therapy on thyroid function. Br J Clin Pharmacol. 1976;3:1041-4. CrossrefMedlineGoogle Scholar4. LIEWENDAHLMAJURI KH. 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Author, Article, and Disclosure InformationAffiliations: Hennepin County Medical Center University of Minnesota Minneapolis, Minnesota PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByThyroid Function TestingTreatment of hypopituitarism in patients receiving antiepileptic drugsGuidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone ReplacementInfluence of Drugs on Thyroid Function TestsThyroid Function TestingHypothyroidismAlteration of thyroid hormone homeostasis by antiepileptic drugs in humans: involvement of glucuronosyltransferase inductionInduction of endogenous pathways by antiepileptics and clinical implicationsRole of the Constitutive Androstane Receptor in Xenobiotic-Induced Thyroid Hormone MetabolismSevere Hypothyroidism as a Complication of Anticonvulsant TreatmentOptimizing Treatment of HypothyroidismEffects Of Carbamazepine On The Hypothalamic-Pituitary-Thyroid Axis„Non-Thyroidal Illness” oder Syndrom veränderter Schilddrüsenhormonparameter bei Patienten mit nichtthyreoidalen ErkrankungenDrugs and Thyroid FunctionThyroid Status of Patients Receiving Long-Term Anticonvulsant Therapy Assessed by Peripheral Parameters: A Placebo-Controlled Thyroxine Therapy TrialOtolaryngologic manifestations of phenytoin toxicityThyroid DisordersTherapy of HypothyroidismThyroid Disease in the Emergency DepartmentSupplementary Thyroxine Therapy in Patients with Hypothyroidism Induced by Long-Term Anticonvulsant TherapyEffect of Rifampin Therapy on Thyroid Function Tests in a Hypothyroid Patient on Replacement L-ThyroxineWILLIAM L. ISLEY, M.D.Iodinated Glycerol-Induced HypothyroidismClinical implications of hepatic microsomal enzyme induction by antiepileptic drugsHypothyroidism and Phenytoin IntoxicationJAMES P. FINNERTY, M.R.C.P.INCREASED FREQUENCY OF GOITRE IN EPILEPTIC PATIENTS ON LONG-TERM PHENYTOIN OR CARBAMAZEPINE TREATMENTHypothyroidismHypothyroidism and Phenytoin IntoxicationMOSHE KUSHNIR, M.D., RUTH WEINSTEIN, M.D., BARUCH LANDAU, M.D., GABRIEL SHAVIT, M.Sc., MARCO BECHAR, M.D., NATAN GADOTH, M.D.Anticonvulsant drugsThyroid hormones and antithyroid drugs 1 September 1983Volume 99, Issue 3Page: 341-342KeywordsDrugsEpileptic seizuresFatigueHypothyroidismThyroid-stimulating hormoneThyroxineTriiodothyronine Issue Published: 1 September 1983 PDF DownloadLoading ...