Triiodothyronine supplementation for hypothalamic obesity.
Patients with suprasellar lesions develop profound hypothalamic obesity and listlessness with no effective treatment. We added triiodothyronine (T(3)) supplementation in 3 such patients and present their response. All had previous nutritional counseling without benefit. All were treated for diabetes insipidus (DI) and hypopituitarism; serum free thyroxine (T(4)) level was normal. A 24-year-old woman (pineal tumor and astrocytoma) had weight gain (4.7 kg/yr for 3 years), cold intolerance, fatigue, dry skin, and constipation; after T(3), she lost 14 kg over 27 months and reported overall improvement. Her bone mineral density also improved. A 10.6-year-old boy (optic glioma) was gaining 6 kg/yr for 4 years; after T(3) supplement, he lost 4.3 kg over 11 months. A 12-year-old girl (mixed germ cell tumor) had weight gain (8.3 kg/yr for 3 years) and listlessness; after T(3), she lost 8.1 kg over 16 months and had improved alertness. All patients were asymptomatic despite supraphysiologic T(3) levels. We suggest that T(3) may serve as a simple and effective supplement, which can promote weight loss and improve the well being of these patients with hypothalamic obesity.
Fernandes
J K
JK
Department of Endocrinology and the Division of Pediatrics, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
Klein
M J
MJ
Ater
Joann L
JL
Kuttesch
John F
JF
Vassilopoulou-Sellin
Rena
R
D000328:Adult; D001932:Brain Neoplasms / Q000150:complications*; D002648:Child; D005260:Female; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications* / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D009765:Obesity / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome; D014284:Triiodothyronine / Q000627:therapeutic use*; D015431:Weight Loss
D014284:Triiodothyronine