In order to clarify the iodine metabolism of hyperthyroidism, thyroid hormone secretion (HS), thyroxine distribution space (TDS) and extrathyroidal organic iodine (EOI) were investigated with the assumption that iodine pool in the body was divided into three compartments [thyroidal organic iodine (TOI), EOI and inorganic iodine]. Subjects used in the present study were hospitalized euthyroid and hyperthyroid patients. One dose of one hundred μc of I
131 was administered intravenously. At intervals there-after, I
131 uptake was measured, blood was drawn for PBI
131 determination. Urine and feces were collected for the assay of radioactivity.
Decay curve of the thyroid uptake following a peak uptake was seen as exponential. Let T and E be the radioactivity in terms of I
131 in the thyroid and extrathyroidal organic iodine, respectively, at any time, t. Let λ
TE and λ
EI be the rate constants of secretion of thyroid hormone and of breakdown of thyroid hormone to inorganic iodine, respectively :
at T =peak, T=T
0 ; at E = peak, E E
1 and T =- T
1.
Then, T= T
1 + (T
0- T
1) e
-kt… (1)
E=T
0 -T =E
1 (1-e
-kt),
∴E
1 -E=E
1e
-kt … (2)
where K is calculated from the curve for the formula (2) by plotting on semi-logarithmic graph paper.
Here, K=λ
TE + λEI
The thyroid hormone secretion must be the same as the degradation of extrathyroidal organic iodine (extrathyroidal thyroxine) quantitatively, provided that the extrathyroidal organic iodine is constant.
Therefore, Tλ
TE = EλEI.
where, Tλ
TE thyroid hormone secretion
Eλ
EI = degradation of extrathyroidal organic iodine
Solving from both equations, Tλ
TE and Tλ
EI are calculated.
Let U and F be I
131 in the urine and feces, then the thyroxine distribution space is calculated as follows :
Thyroxine distribution space (TDS)
T
0-T
1- (∑U-U
0) -∑F/Peak PBI
131 Extrathyroidal organic iodine (EOI)
=TDS × (PBI × 10)
Thyroidal organic iodine (TOI)
= EOI ×T
1 /E
1 Thyroid hormone secretion (HS)
Reutilization of thyroid hormone (R) T
0/ T
0+U
0×T
1 λ
TE -F//T
1 λ
TE U
0 : Urinary I
131 excretion until I
131 thyroid uptake reaches peak after tracer dose
1) There was no difference in TDS and TOI between euthyroid and hyperthyroid.
2) EOI and HS were higher in hyperthyroid than in euthyroid.
3) I
131 peak thyroid uptake and I
131 thyroid clearance were not correlative with TOI.
4) With the days of peak PBI
131 after tracer dose prolonged in hyperthyroid, HS was low, but TOT became high.
There was no correlation between EOI and the days of peak PBI
131 after tracer dose.
5) In hyperthyroid peak PBI
131 was most influenced by TOI, since peak PBI
131 was markedly correlative with TOI and moderately with Total OI, but not with HS and EOI.
6) HS was correlative with λ
TE but not with TOI.
7) The γ values between HS and other thyroid function tests were as follows,
(PBI)
2 γ= +0.69 (P<0.01)
PBI γ= +0.65 (P<0.01)
I
131 peak thyroid uptake γ= +0.60 (P<0.01)
I
131 thyroid clearance γ= +0.58 (P<0.01)
BMR γ= +0.46 (P<0.01)
8) In hyperthyroid TOI revealed the tendency to decrease in patients over 40 years of age,
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