Abnormal thyroid function test results in patients taking salsalate.
OBJECTIVE
To evaluate how the nonsteroidal anti-inflammatory agent salsalate affects the results of routine thyroid function tests.


METHODS
In a cohort of patients taking salsalate for various rheumatic conditions, thyroid function tests were performed with patients on and off the drug.


METHODS
Primary care of ambulatory patients in a university medical center.


METHODS
A convenience sample of 14 euthyroid subjects, none of whom was taking thyroid hormone or other medication recognized to alter thyroid function.


METHODS
Treatment with therapeutic doses of salsalate for a mean period of 44 weeks.


METHODS
Serum levels of thyroxine (T4), free T4, thyroid hormone binding ratio, free T4 index (the product of T4 and the thyroid hormone binding ratio), triiodothyronine, and thyrotropin.


RESULTS
Serum T4 dropped from a mean baseline level of 96.7 nmol/L off salsalate to 53.4 nmol/L on it (P less than .001), and the free T4 index showed a parallel decline from 85.9 to 50.4 (P less than .001), with both values falling into the hypothyroid range. Similarly, free T4 levels and total triiodothyronine concentrations were low in several patients treated with salsalate. Serum thyrotropin levels declined transiently, falling from a mean of 3.2 to 1.7 mU/L (P less than .02) in patients treated for less than 3 weeks. Patients treated for longer periods had levels comparable to baseline. Despite these changes in the thyroid function test results, all subjects remained clinically euthyroid.


CONCLUSIONS
Salsalate commonly produces abnormalities in routine thyroid function test results similar to those found in central hypothyroidism.
McConnell
R J
RJ
Columbia University College of Physicians and Surgeons, New York, NY.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000139:chemically induced* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012216:Rheumatic Diseases / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D012459:Salicylates / Q000009:adverse effects*; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000187:drug effects* / Q000503:physiopathology; D013963:Thyroid Hormones / Q000097:blood; D013974:Thyroxine / Q000097:blood
D012459:Salicylates; D013963:Thyroid Hormones; D013974:Thyroxine; C014182:salicylsalicylic acid