Haraguchi K, Aida K, Akasu F, Takazawa K, Onaya T
Endocrinol Jpn. 1986 Feb;33(1):61-5. doi: 10.1507/endocrj1954.33.61.
A 39-year-old woman who had been suffering from anorexia nervosa was found to have hypothyroidism. Serum T4, free T4, T3, free T3 and TSH were 3.19 micrograms/dl, 0.5 ng/dl, 15.3 ng/dl, 1.2 pg/ml and 162.1 microU/ml, respectively. On careful questioning, she was found to have taken an iodine-rich diet. The serum iodine concentration was 122 micrograms/dl (normal: 4-9 micrograms/dl) and urinary iodide excretion was 13.05 mg/day (normal: less than 2 mg). After withdrawal of the iodine-rich diet, her serum T4 gradually increased and TSH returned to the normal range. She was diagnosed as having iodide-induced hypothyroidism. However, no significant elevation of serum T3 or free T3 was observed. Serum T4, free T4, T3, free T3 and TSH were 7.85 micrograms/dl, 0.8 ng/dl, 13.6 ng/dl, 4.3 pg/ml and 6.02 microU/ml, respectively. The iodide-perchlorate discharge test result was negative. These findings suggest that there exists some unknown mechanism by which a patient with anorexia nervosa may be sensitive to excess iodide. Furthermore, it is of interest to note that in a recovery phase from the hypothyroid state, normalization of serum T4 rather than T3 is well-correlated to TSH secretion.
一名患有神经性厌食症的39岁女性被发现患有甲状腺功能减退症。血清总甲状腺素（T4）、游离甲状腺素（free T4）、三碘甲状腺原氨酸（T3）、游离三碘甲状腺原氨酸（free T3）和促甲状腺激素（TSH）分别为3.19微克/分升、0.5纳克/分升、15.3纳克/分升、1.2皮克/毫升和162.1微国际单位/毫升。经仔细询问，发现她摄入了富含碘的饮食。血清碘浓度为122微克/分升（正常范围：4 - 9微克/分升），尿碘排泄量为13.05毫克/天（正常范围：小于2毫克）。停止摄入富含碘的饮食后，她的血清T4逐渐升高，TSH恢复到正常范围。她被诊断为碘诱发的甲状腺功能减退症。然而，未观察到血清T3或游离T3有明显升高。血清T4、游离T4、T3、游离T3和TSH分别为7.85微克/分升、0.8纳克/分升、13.6纳克/分升、4.3皮克/毫升和6.02微国际单位/毫升。碘 - 过氯酸盐释放试验结果为阴性。这些发现表明，存在某种未知机制，使得神经性厌食症患者可能对过量碘敏感。此外，值得注意的是，在甲状腺功能减退状态的恢复阶段，血清T4而非T3的正常化与TSH分泌密切相关。
