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Arshag Mooradian, MD; John E. Morley, MB, BCh; Geza Simon, MD; Rex B. Shafer, MD

Arch Intern Med. 1983;143(11):2193-2195.

Abstract
• A patient on a regimen of 400 mg/day of propranolol hydrochloride was observed to have elevated thyroxine (T₄) and free T₄ levels with a normal thyrotropin response to protirelin. This led us to study the prevalence of hyperthyroxinemia in 14 consecutively treated patients with hypertension on daily doses of propranolol of 320mg or more. Four of 14 patients had elevated serum T₄ levels. As a group, the patients on propranolol therapy had higher serum T₄ levels, free T₄ indices, and triiodothyronine levels than did healthy controls. The use of high-dosage propranolol may be associated with euthyroid hyperthyroxinemia and be a source of diagnostic confusion. All patients receiving therapy with high-dosage propranolol should undergo protirelin testing before one can conclude that their elevated thyroid hormone levels are due to hyperthyroidism.

(Arch Intern Med 1983;143:2193-2195)

Author Affiliations
From the Neuroendocrine Research Laboratory and Division of Nuclear Medicine, Minneapolis Veterans Administration Medical Center (Drs Shafer and Morley), and the Division of Endocrinology, Department of Medicine, University of Minnesota, Minneapolis (Drs Mooradian and Simon).

Footnotes
Accepted for publication Feb 10, 1983.

Reprint requests to VA Medical Center, 54th Street and 48th Avenue S, Minneapolis, MN 55417 (Dr Shafer).

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