Changes in thyroid function tests during short-term salsalate use.
Although long-term administration of salsalate depresses blood levels of both total thyroxine (T4) and total triiodothyronine (T3) and at least transiently decreases serum thyrotropin (TSH), changes in thyroid function tests have not been fully characterized during its short-term use. It is also unclear if the observed changes are solely the result of decreased hormone binding to carrier proteins or if reduced hepatic 5'-monodeiodinase activity is important. Blood was sampled at baseline (day 0) and after 24 hours (day 1) and 72 hours (day 3) in eight subjects taking a therapeutic dose of salsalate 1,500 mg twice daily. Total T4 decreased from 90.1+/-7.7 nmol/L (mean+/-SD) on day 0 to 82.9+/-8.6 nmol/L on day 1 (P=.1 v baseline) and 68.6+/-8.7 nmol/L on day 3 (P=.0001). Total T3 decreased from 1.76+/-0.20 nmol/L to 1.61+/-0.16 nmol/L on day 1 (P<.05) and 1.31+/-0.27 nmol/L on day 3 (P=.002). The T4/T3 ratio was 51.7+/-7.7 at baseline and remained unchanged after 3 days. Levels of reverse T3 (rT3) were reduced from 0.24+/-0.05 nmol/L to 0.18+/-0.02 nmol/L on day 3 (P<.05). While the free T4 index (FTI) declined in parallel with total T4, the free T4 level by direct equilibrium dialysis (FTD) was unchanged after 3 days. Serum TSH decreased from 1.47+/-0.47 mU/L to 0.91+/-0.27 mU/L after 1 day (P<.05) and remained suppressed after 3 days (0.95+/-0.49 mU/L, P<.05). In conclusion, (1) therapeutic doses of salsalate significantly decrease serum concentrations of total T4, total T3, and rT3 to about 75% of baseline levels after 3 days without altering the T4/T3 ratio; (2) although the FTD does not change, serum TSH concentrations remain suppressed; and (3) the proportionate decrease in total thyroid hormone levels suggests that inhibition of hormone binding to serum proteins is more important in producing these changes than reduced hepatic 5'-monodeiodinase activity.
McConnell
R J
RJ
The Thyroid Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology*; D001798:Blood Proteins / Q000378:metabolism; D005260:Female; D006801:Humans; D007453:Iodide Peroxidase / Q000097:blood / Q000378:metabolism; D008099:Liver / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D012459:Salicylates / Q000494:pharmacology*; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000187:drug effects*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014285:Triiodothyronine, Reverse / Q000097:blood
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001798:Blood Proteins; D012459:Salicylates; D014285:Triiodothyronine, Reverse; D013972:Thyrotropin; D007453:Iodide Peroxidase; D013974:Thyroxine; C014182:salicylsalicylic acid