Impairment in cognitive and exercise performance during prolonged antarctic residence: effect of thyroxine supplementation in the polar triiodothyronine syndrome.
Humans who work in Antarctica display deficits in cognition, disturbances in mood, increased energy requirements, a decline of thyroid hormone products, and an increase of serum TSH. We compared measurements in 12 subjects, before deployment (baseline), with 11 monthly studies during Antarctic residence (AR). After 4 months of AR (period 1), half of the subjects (T(4) group) received L-thyroxine [64 nmol.day(-)(1) (0.05 mg.day(-)(1))]; and the other half, a placebo (placebo group) for the next 7 months of AR (period 2). During period 1, there was a 12.3 +/- 5.1% (P < 0.03) decline on the matching-to-sample (M-t-S) cognitive task and an increase in depressive symptoms, compared with baseline. During the intervention in period 2, M-t-S scores for the T(4)-treated group returned to baseline values; whereas the placebo group, in contrast, showed a reduced M-t-S score (11.2 +/- 1.3%; P < 0.0003) and serum free T(4) (5.9 +/- 2.4%; P < 0.02), compared with baseline. The change in M-t-S score was correlated with the change in free T(4) (P < 0.0003) during both periods, and increases in serum TSH preceded worsening scores in depression, tension, anger, lack of vigor, and total mood disturbance (P < 0.001) during period 2. Additionally, the submaximal work rate for a fixed O(2) use decreased 22.5 +/- 4.9% in period 1 and remained below baseline in period 2 (25.2 +/- 2.3%; P < 0.005) for both groups. After 4 months of AR, the L-thyroxine supplement was associated with improved cognition, which seems related to circulating T(4). Submaximal exercise performance decrements, observed during AR, were not changed with this L-thyroxine dose.
Endocrine Service, Department of Medicine, Madigan Army Medical Center, Tacoma, Washington 98431, USA. lreed@middlemore.co.nz
H L
HL
Reed
K R
KR
Reedy
L A
LA
Palinkas
N
N
Van Do
N S
NS
Finney
H S
HS
Case
H J
HJ
LeMar
J
J
Wright
J
J
Thomas
D000328:Adult; D000339:Affect / Q000187:drug effects; D000864:Antarctic Regions; D003071:Cognition / Q000187:drug effects / Q000502:physiology*; D003081:Cold Climate; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D010101:Oxygen Consumption / Q000187:drug effects; D013963:Thyroid Hormones / Q000097:blood*; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use*; D013997:Time Factors; D014284:Triiodothyronine / Q000097:blood
D013963:Thyroid Hormones; D014284:Triiodothyronine; D013974:Thyroxine