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Depressed Thyroid Indexes Associated With Occupational Exposure to Inorganic Lead

Depressed Thyroid Indexes Associated With Occupational Exposure to Inorganic Lead Abstract • The finding of low values for serum thyroxine and estimated free thyroxine in seven of 12 workers referred because of elevated blood lead levels (>40 mg/L) prompted further investigation. In a cross-sectional study of workers at a small foundry, both measurements were found to regress negatively with blood lead level. In 12 of 47 subjects, both indexes were in the hypothyroid range. Serum thyrotropin and triiodothyronine levels in patients and study subjects with low indexes were all normal. Physical examinations failed to demonstrate the classic features of hypothyroidism. These data are compatible with a central depression of the thyroid axis or an alteration in thyroxine metabolism or binding to proteins. Irrespective of mechanism, the association between low thyroid indexes and elevated lead levels merits attention because of the large number of workers exposed to lead and the similarities between the clinical features of adult lead poisoning and hypothyroidism. (Arch Intern Med 1983;143:220-224) References 1. Morgan J, Hartley MW, Miller RE: Nephropathy in chronic lead poisoning. Arch Intern Med 1966;118:17-29.Crossref 2. National Occupational Hazard Survey , publication NIOSH 74-127. US Dept of Health, Education, and Welfare, 1974. 3. Monaenkova AM: Functional state of the thyroid gland in chronic intoxication with some industrial poisons. Gig Tr Prof Zabol 1957;1:44-48. 4. Sandstead HH, Stant EG, Brill AB, et al: Lead intoxication and the thyroid. Arch Intern Med 1969;123:632-635.Crossref 5. Sandstead HH: Effect of chronic lead intoxication on in vivo I131 uptake by the rat thyroid. Proc Soc Exp Biol Med 1967;124:18-20.Crossref 6. Slingerland DW: The influence of various factors on the uptake of iodine by the thyroid. J Clin Endocrinol Metabol 1955;15:131-141.Crossref 7. Seligson H, Seligson D: Measurement of thyroxine by competitive protein binding. Clin Chem Acta 1972;38:199-205.Crossref 8. Seligson H, Seligson D: Measurement of serum thyroxine binding capacity. Clin Chem Acta 1978;89:47-58.Crossref 9. Odell WD, Webber JW, Paul WE: Radioimmunoassay of thyrotropin in human serum. J Clin Endocrinol Metabol 1965;25:1179-1188.Crossref 10. Jackson I: Thyrotropin releasing hormone. N Engl J Med 1981;306: 145-155.Crossref 11. Cullen MJ, Burger AG, Ingbar SH: Effects of diphenylhydantoin on peripheral thyroid hormone economy and conversion of T4 to T3. Isr J Med Sci 1972;8:1868. 12. Cavalieri R, Gavin LA, Wallace A, et al: Serum thyroxine, free T4, triiodothyroxine and reverse-T3 in diphenylhydantoin-treated patients. Metabolism 1979;28:1161-1165.Crossref 13. Chopra IJ, Solomon DH, Teco GNC, et al: An inhibitor of the binding of thyroid hormones to serum proteins is present in extrathyroidal tissues. Science 1982;215:407-408.Crossref 14. Henkin RI: Trace metals in endocrinology. Med Clin North Am 1976;60:779-797. 15. Jelinek JM, Marham O, Seda M: The effects of copper sulfate on pituitary LH in rats. Endocrinol Exp 1970;4:37-43. 16. Bahn AK, Mills JL, Snyder PJ, et al: Hypothyroidism in workers exposed to polybrominated biphenyls. N Engl J Med 1980;320:31-33.Crossref 17. Cavalleri A: Serum thyroxine in the early diagnosis of carbon disulfide poisoning. Arch Environ Health 1975;30:85-87.Crossref 18. Robbins J, Rail JE: The iodine-containing hormones , in Gray CH, James VHT (eds): Hormones in Blood . London, Academic Press, Inc, 1979, pp 638-639. 19. Landrigan PJ, Baker EL, Himmelstein JS, et al: Exposure to lead from the Mystic River bridge: The dilemma of deleading. N Engl J Med 1982;306:373-376.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Depressed Thyroid Indexes Associated With Occupational Exposure to Inorganic Lead

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1983.00350020038008
Publisher site
See Article on Publisher Site

Abstract

Abstract • The finding of low values for serum thyroxine and estimated free thyroxine in seven of 12 workers referred because of elevated blood lead levels (>40 mg/L) prompted further investigation. In a cross-sectional study of workers at a small foundry, both measurements were found to regress negatively with blood lead level. In 12 of 47 subjects, both indexes were in the hypothyroid range. Serum thyrotropin and triiodothyronine levels in patients and study subjects with low indexes were all normal. Physical examinations failed to demonstrate the classic features of hypothyroidism. These data are compatible with a central depression of the thyroid axis or an alteration in thyroxine metabolism or binding to proteins. Irrespective of mechanism, the association between low thyroid indexes and elevated lead levels merits attention because of the large number of workers exposed to lead and the similarities between the clinical features of adult lead poisoning and hypothyroidism. (Arch Intern Med 1983;143:220-224) References 1. Morgan J, Hartley MW, Miller RE: Nephropathy in chronic lead poisoning. Arch Intern Med 1966;118:17-29.Crossref 2. National Occupational Hazard Survey , publication NIOSH 74-127. US Dept of Health, Education, and Welfare, 1974. 3. Monaenkova AM: Functional state of the thyroid gland in chronic intoxication with some industrial poisons. Gig Tr Prof Zabol 1957;1:44-48. 4. Sandstead HH, Stant EG, Brill AB, et al: Lead intoxication and the thyroid. Arch Intern Med 1969;123:632-635.Crossref 5. Sandstead HH: Effect of chronic lead intoxication on in vivo I131 uptake by the rat thyroid. Proc Soc Exp Biol Med 1967;124:18-20.Crossref 6. Slingerland DW: The influence of various factors on the uptake of iodine by the thyroid. J Clin Endocrinol Metabol 1955;15:131-141.Crossref 7. Seligson H, Seligson D: Measurement of thyroxine by competitive protein binding. Clin Chem Acta 1972;38:199-205.Crossref 8. Seligson H, Seligson D: Measurement of serum thyroxine binding capacity. Clin Chem Acta 1978;89:47-58.Crossref 9. Odell WD, Webber JW, Paul WE: Radioimmunoassay of thyrotropin in human serum. J Clin Endocrinol Metabol 1965;25:1179-1188.Crossref 10. Jackson I: Thyrotropin releasing hormone. N Engl J Med 1981;306: 145-155.Crossref 11. Cullen MJ, Burger AG, Ingbar SH: Effects of diphenylhydantoin on peripheral thyroid hormone economy and conversion of T4 to T3. Isr J Med Sci 1972;8:1868. 12. Cavalieri R, Gavin LA, Wallace A, et al: Serum thyroxine, free T4, triiodothyroxine and reverse-T3 in diphenylhydantoin-treated patients. Metabolism 1979;28:1161-1165.Crossref 13. Chopra IJ, Solomon DH, Teco GNC, et al: An inhibitor of the binding of thyroid hormones to serum proteins is present in extrathyroidal tissues. Science 1982;215:407-408.Crossref 14. Henkin RI: Trace metals in endocrinology. Med Clin North Am 1976;60:779-797. 15. Jelinek JM, Marham O, Seda M: The effects of copper sulfate on pituitary LH in rats. Endocrinol Exp 1970;4:37-43. 16. Bahn AK, Mills JL, Snyder PJ, et al: Hypothyroidism in workers exposed to polybrominated biphenyls. N Engl J Med 1980;320:31-33.Crossref 17. Cavalleri A: Serum thyroxine in the early diagnosis of carbon disulfide poisoning. Arch Environ Health 1975;30:85-87.Crossref 18. Robbins J, Rail JE: The iodine-containing hormones , in Gray CH, James VHT (eds): Hormones in Blood . London, Academic Press, Inc, 1979, pp 638-639. 19. Landrigan PJ, Baker EL, Himmelstein JS, et al: Exposure to lead from the Mystic River bridge: The dilemma of deleading. N Engl J Med 1982;306:373-376.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Feb 1, 1983

References