Clinical manifestations of hypometabolism in women

Abstract

Hypometabolism, whether caused by a subnormal activity of the thyroid gland or faulty delivery or utilization of thyroid products, was found to occur in 13 per cent of the approximately 800 women treated at the gynecologic service of a general clinic during 1955 and 1956.The most common signs and symptoms of hypometabolism were chronic fatigue, enlarged thyroid gland, gynecologic disorders, dry hair, and nervousness and irritability. The most frequent gynecologic disorders were adnexal congestion, pelvic pain, adnexal tenderness, and menstrual irregularity.Liothyronine (3, 5, 3′ l-triiodothyronine) proved to be an effective medication for relieving the clinical signs and symptoms of hypometabolism.Of 102 women who had never received thyroid medication prior to treatment with liothyronine, 49 women (48.0 per cent of the group) were entirely relieved of all signs and symptoms by liothyronine and another 49 women (48.0 per cent) had a reduction in the number and severity of signs and symptoms. Only 4 women (4.0 per cent) showed no improvement under liothyronine therapy. Before therapy, the median number of signs and symptoms in these patients was 9; under therapy, the average patient who had any manifestations of hypometabolism had only 2 and these were less severe.Of 90 women who were incompletely responsive to therapy with desiccated thyroid in doses that they could tolerate, 39 women (43.4 per cent of the group) were completely freed of all clinical signs and symptoms of hypometabolism when they received liothyronine therapy. Forty-three patients (47.7 per cent) had a reduction in the number and severity of signs and symptoms when receiving liothyronine therapy; 6 patients (6.7 per cent) showed no important improvement; and 2 patients (2.2 per cent) said they felt worse. While on desiccated thyroid therapy the average patient had 5 signs and symptoms of hypometabolism; under liothyronine therapy, the average patient who had any manifestations of the disorder had only 2 less severe signs or symptoms.Although the stress of the report is on the clinical signs and symptoms of hypometabolism, the importance of laboratory tests must not be ignored. In the absence of laboratory tests, however, a therapeutic trial with liothyronine in patients suspected of hypometabolism is often desirable and beneficial. Since many patients who are incompletely responsive to thyroid hormone respond to liothyronine, the latter is the preferable drug for trial.