Effect of domperidone on serum TSH and growth hormone in thyroid patients.

In euthyroid female patients, the release of TSH from the pituitary increases in response to domperidone, a dopaminergic-receptor blocking agent of peripheral action. The rate of increase varies with the functional state of the thyroid, as confirmed by results obtained in cases of euthyroidism, primary hypothyroidism, subclinical hypothyroidism and subclinical hyperthyroidism. Observations suggest that the more vigorous feedback-mechanism modulates the dopaminergic regulation of TSH-secretion at a high degree of sensitivity. Stimulation with 1-dopa intensifies the release of growth hormone from the pituitary which is, however, of lesser degree in hyperthyroid or hypothyroid than in euthyroid individuals. The GH-response to 1-dopa is enhanced by administration of propranolol, but the maximum serum GH levels in response to stimulation with 1-dopa are significantly lower in hyperthyroid than in euthyroid individuals. Administration of domperidone leaves the serum GH levels unaffected in euthyroid and hyperthyroid subjects, but causes a significant increase in a number of patients with primary hypothyroidism. The results suggest that the dopaminergic system plays a part in the regulation of TSH and GH secretion, asserting itself partly as a direct effect on the pituitary, and that the dopaminergic regulation may be affected by thyroid dysfunction.