New Tactics for Hyperthyroidism: Sympathetic Blockade
Authors: MATTHEW C. RIDDLE
Journal: Annals of Internal Medicine (1970)

Editorials1 May 1970New Tactics for Hyperthyroidism: Sympathetic BlockadeMATTHEW C. RIDDLE, M.D., THEODORE B. SCHWARTZ, M.D.MATTHEW C. RIDDLE, M.D.Search for more papers by this author, THEODORE B. SCHWARTZ, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-5-749 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe similarity between signs and symptoms of hyperthyroidism and of excessive adrenergic activity is well known. Though it is clear that the thyroid hormones have many direct metabolic effects, the balance of experimental evidence supports the idea that increased tissue sensitivity to catecholamines also contributes much to the clinical picture of hyperthyroidism (1). The well-known studies of Brewster, Isaacs, and Osgood (2) showed that epidural blockade inhibited many, particularly cardiovascular, effects of thyroid feeding in dogs, presumably by eliminating sympathetic nervous activity. The idea of using sympatholytic agents as therapy for thyrotoxicosis in man followed naturally from this observation. Spinal...References1. HARRISON T: Adrenal medullary and thyroid relationships. Physiol Rev 44:161-185, 1964 CrossrefMedlineGoogle Scholar2. BREWSTERISAACSOSGOOD WJP: The hemodynamic and metabolic interrelationships in the activity of epinephrine, norepinephrine, and the thyroid hormones. Circulation 13:1-20, 1956 CrossrefMedlineGoogle Scholar3. KNIGHT R: The use of spinal anesthesia to control sympathetic overactivity in hyperthyroidism. Anesthesiology 6:225-230, 1945 CrossrefGoogle Scholar4. CANARYSCHAFFDUFFY JMB: Effects of oral and intramuscular administration of reserpine in thyrotoxicosis. New Eng J Med 257:435-442, 1957 CrossrefMedlineGoogle Scholar5. WALDSTEINWESTLEE SGW: Guanethidine in hyperthyroidism. JAMA 189:609-612, 1964 CrossrefMedlineGoogle Scholar6. SHANKSHADDENLOWE RDD: Controlled trial of propranolol in thyrotoxicosis. Lancet 1:993-994, 1969 CrossrefMedlineGoogle Scholar7. HOWITTROWLANDS GD: Beta-sympathetic blockade in hyperthyroidism. Lancet 1:628-631, 1966 CrossrefMedlineGoogle Scholar8. PARSONSJEWITT VD: Beta-adrenergic blockade in the management of acute thyrotoxic crisis, tachycardia and arrhythmias. Postgrad Med J 43:756-762, 1967 CrossrefMedlineGoogle Scholar9. MARSDENGIMLETTEMCALLISTER CTR: Effect of beta-adrenergic blockade on finger tremor and Achilles reflex time in anxious and thyrotoxic patients. Acta Endocr (Kobenhavn) 57:353-362, 1968 CrossrefMedlineGoogle Scholar10. LEEBRONSKYWALDSTEIN WDS: Studies of thyroid and sympathetic nervous system interrelationships. II. Effects of guanethidine on manifestations of hyperthyroidism. J Clin Endocr 22:879-885, 1962 CrossrefMedlineGoogle Scholar11. PIMSTONEMARINEPIMSTONE NNB: Beta-adrenergic blockade in thyrotoxic myopathy. Lancet 2:1219-1220, 1968 CrossrefMedlineGoogle Scholar12. GOLDSTEINKILLIP ST: Catecholamine depletion in thyrotoxicosis. Effect of guanethidine on cardiovascular dynamics. Circulation 31:219-227, 1965 CrossrefMedlineGoogle Scholar13. HOWITTROWLANDSLEUNG GDD: Myocardial contractility, and the effects of beta-adrenergic blockade in hypothyroidism and hyperthyroidism. Clin Sci 34:485-495 1968 MedlineGoogle Scholar14. GAFFNEYBRAUNWALDKAHLER TER: Effects of guanethidine on tri-iodothyronine-induced hyperthyroidism in man. New Eng J Med 265:16-20, 1961 CrossrefMedlineGoogle Scholar15. STOUTWIENERCOX BLJ: Combined alpha and beta sympathetic blockade in hyperthyroidism: clinical and metabolic effects. Ann Intern Med 70:963-970, 1969 LinkGoogle Scholar16. CANTLEWISHARRISON JDM: Treatment of dysthyroid opthalmopathy with local guanethidine. Brit J Ophthal 53:233, 1969 CrossrefMedlineGoogle Scholar17. MCDEVITTSHANKSHADDEN DRD: The role of the thyroid in control of heart-rate. Lancet 1:998-1000, 1968 CrossrefMedlineGoogle Scholar18. BLUMENTHALDAVISDOE MRR: Carcinoid syndrome following reserpine therapy in thyrotoxicosis. Arch Intern Med (Chicago) 116:819-823, 1965 CrossrefMedlineGoogle Scholar19. DASKRIEGER GM: Treatment of thyrotoxic storm with intravenous administration of propranolol. Ann Intern Med 70:985-988, 1969 LinkGoogle Scholar20. VINIKPIMSTONEHOFFENBERG ABR: Sympathetic nervous system blockade in hyperthyroidism. J Clin Endocr 28:725-727, 1968 CrossrefMedlineGoogle Scholar21. HADDENMONTGOMERYSHANKS DDR: Propranolol and iodine-131 in the management of thyrotoxicosis. Lancet 2:852-854, 1968 CrossrefMedlineGoogle Scholar22. PIMSTONEJOFFEPIMSTONE BBN: Clinical response to long-term propranolol therapy in hyperthyroidism. S Afr Med J 2:1203-1205, 1969 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: MATTHEW C. RIDDLE, M.D.; THEODORE B. SCHWARTZ, M.D.Affiliations: Section of Endocrinology and Metabolism Presbyterian-St. Luke's Hospital and the University of Illinois Chicago, Ill. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byGraves' DiseasePropranolol and thyroxine-induced hypertrophic rabbit hearts: Effect on heart size and regional O2 supply/consumption variablesHeart failure in sinus rhythm as the sole manifestation of Graves' diseaseIdentification and Characterization of Thyroid Hormone Receptors and Action Using Cell Culture TechniquesPROPRANOLOL VERSUS CARBIMAZOLE AS THE SOLE TREATMENT FOR THYROTOXICOSIS. 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Causes, etiology of Graves’ disease, clinical features, general aspects of treatmentThyroid stormThe adrenergic nervous system in hyperthyroidism: Therapeutic role of beta adrenergic blocking drugsAdrenergic beta-receptor blockade in hyperthyroidism.Urticaria and hyperthyroidismMetabolic effects of propranolol in thyrotoxicosis. I. Nitrogen, calcium, and hydroxyprolineAdrenergic-Blocking Drugs in HyperthyroidismL. A. DISTILLER, F.C.P.(S.A.), B. I. JOFFE, M.R.C.P., H. C. SEFTEL, DIP. MED.Thyrotoxic Crisis and Myxedema ComaComparison between reserpine and propranolol as adjuncts in the treatment of hyperthyroidismPathogenesis and Treatment of ThyrotoxicosisEffects of Beta Blockade on the Peripheral Manifestations of ThyrotoxicosisWILLIAM GROSSMAN, M.D., NOEL I. ROBIN, M.D., LEWIS W. JOHNSON, M.D., HAROLD BROOKS, M.D., HERBERT A. SELENKOW, M.D., F.A.C.P., LEWIS DEXTER, M.D., F.A.C.P.The Management of Hypertension Associated with Disorders of Function of the Endocrine Glands (“Endocrine Hypertension“)New Tactics for Hyperthyroidism: Sympathetic BlockadeBARRY I. JOFFE, M.R.C.P., BERNARD L. PIMSTONE, M.R.C.P.JUNIOR HOSPITAL STAFF IN TRAININGEFFECT OF PROPRANOLOL ON SERUM-THYROXINE 1 May 1970Volume 72, Issue 5Page: 749-751KeywordsCatecholaminesHyperthyroidismSigns and symptomsThyroidThyroid hormones ePublished: 1 December 2008 Issue Published: 1 May 1970 PDF downloadLoading ...