Subnormal energy expenditure: a putative causal factor in the weight gain induced by treatment of hyperthyroidism.
OBJECTIVE
To examine the causes of weight gain occurring as an adverse effect of treatment of hyperthyroidism.


METHODS
We measured 24-h energy expenditure (EE), body composition and spontaneous physical activity (SPA) in eight patients before and 1 year after treatment of hyperthyroidism was initiated, and eight controls.


RESULTS
One year after initiation of treatment thyrotropin was normalized, thyroid hormones had fallen to the lower end of the reference range and fat mass had increased by 3.5 kg (p < 0.001). Twenty-four hour EE adjusted for fat-free mass (FFM) was 15% higher in hyperthyroid patients before treatment than in controls (p = 0.003), and treatment decreased 24-h EE by 1.9 MJ/day (p = 0.001). After treatment, 24-h EE, adjusted for FFM, was similar to the controls. Multiple regression analyses showed that the suppressed EE could partly be attributed to an iatrogenic suppression of thyroid hormones, resulting in lower sleeping EE. Twenty-four hour SPA was normal in the hyperthyroid state, but decreased after treatment by 21% (p = 0.045), to a level not significantly different, but still below that of the controls.


CONCLUSIONS
The study suggests that weight gain during treatment of hyperthyroidism might be due to subnormal levels of EE and SPA caused by a suppression of the thyroid hormone to a level in the lower end of the normal range.
Jacobsen
R
R
Department of Human Nutrition, Centre for Advanced Food Studies, The Royal Veterinary and Agricultural University, Frederiksberg C, Denmark.
Lundsgaard
C
C
Lorenzen
J
J
Toubro
S
S
Perrild
H
H
Krog-Mikkelsen
I
I
Astrup
A
A
D001823:Body Composition; D016022:Case-Control Studies; D002940:Circadian Rhythm; D004734:Energy Metabolism / Q000502:physiology*; D015444:Exercise; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006980:Hyperthyroidism / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D013963:Thyroid Hormones / Q000378:metabolism; D015430:Weight Gain / Q000502:physiology*
D013963:Thyroid Hormones