Normal Basal Metabolic Rate Research Articles

Therapeutic studies in hyperthyroidism; methimazole.

INTRODUCTION In the last few years many new agents have been presented to the clinician for the treatment of hyperthyroidism. A great deal of experience and the collected reports of many investigators are necessary before the final role of each of these substances can be definitely determined. The burden of this report will be to contribute experience with one of these new agents, methimazole.1 Methimazole (1-methyl-2-mercaptoimidazole) was first reported by Stanley and Astwood (1) as “an antithyroid compound highly effective in man” in June, 1949. They observed that as small a dose as 0.5 mg. had a marked inhibitory effect on the uptake of radioactive iodine by the thyroid gland. Five milligrams completely inhibited the uptake for twenty-four hours. In 1950 two papers appeared to further the use of the drug. Beierwaltes (2) treated 9 patients of various ages; 6 showed a rapid return to a normal basal metabolic rate, but 3 did not show any return to a normal rate over a period of three months or more. He ...

Acid soluble phosphorus compounds in human blood investigated with radioactive phosphorus. III. The action of thyroid hormone administered to two persons with normal basal metabolic rate.

(1951). Acid Soluble Phosphorus Compounds in Human Blood Investigated with Radioactive Phosphorus: III. The Action of Thyroid Hormone Administered to Two Persons with Normal Basal Metabolic Rate. Scandinavian Journal of Clinical and Laboratory Investigation: Vol. 3, No. 3, pp. 174-174.

Problems in the Treatment of Cardiac Failure in Myxedema

THE SPECIFIC origin of myxedema in thyroid deficiency implies a therapy so simple and so adequate as to warrant little amplification. However, it has long been recognized that all types of hypothyroid patients tolerate thyroid hormone less well than individuals with normal basal metabolic rates. Moreover, Means and his associates (1) have demonstrated rather clearly that the actual initial and maintenance dosages to be used vary considerably from subject to subject. Some of their patients needed 3 grains of desiccated thyroid substance daily; others were relieved of the majority of their symptoms with as little as ½ grain daily, although basal metabolic rates were never normal with this amount of material. In the majority of patients, this problem of tolerance is dependent upon cardiovascular disturbances. These may be due solely to the myxedematous state, or may represent pre-existing lesions which are aggravated by the metabolic changes present in myxedema.

BASAL METABOLISM OF TUBERCULOUS CHILDREN

During the past five years we have had an unusual opportunity at Sea View Hospital to study the basal metabolism of tuberculous children in almost every phase of the infection. The results of our previous studies may be summarized as follows: Of 115 children with active afebrile pulmonary tuberculosis of the adult, or reinfection, type, 92, or 80 per cent, had a normal basal metabolic rate (between + 10 and −10 per cent). The metabolism remained normal even in the presence of extensive pulmonary pathologic change.1In this respect, the results agreed in the main with those reported in the literature for adults with the same type of infection.2 Studies of the basal metabolism of 66 children in whom pneumothorax had been instituted indicated that the basal metabolism was lowered by this procedure. The longer the pneumothorax was maintained, the lower the metabolic rate seemed to fall. From + 7

BASAL METABOLISM OF TUBERCULOUS CHILDREN

In a previous publication1a preliminary report was made of a study of the basal metabolism of tuberculous children which is being carried out in the pediatric service of the Sea View Hospital. This report was concerned especially with the metabolism of patients with afebrile pulmonary tuberculosis. Of 115 children with active afebrile tuberculosis of the adult, or reinfection, type, 92, or 80 per cent had a normal basal metabolic rate (between + 10 and− 10 per cent). In this respect the results agreed in the main with those reported in the literature for adults with afebrile pulmonary tuberculosis. Of 143 children with active afebrile tuberculosis of the primary, or childhood, type, only 6, or 4 per cent, had a normal basal metabolic rate. The remaining 137 children, or 96 per cent, had a rate above + 10 per cent. The standard used was that of von Pirquet,2which is

CIRCULATION TIME AS A DIAGNOSTIC AID IN HYPERTHYROIDISM

Article1 April 1938CIRCULATION TIME AS A DIAGNOSTIC AID IN HYPERTHYROIDISMSAMUEL J. GOLDBERG, M.D., F.A.C.P.SAMUEL J. GOLDBERG, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-11-10-1818 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe satisfactory results of present day treatment of hyperthyroidism make it essential that an accurate diagnosis be made before the late effects of the disease damage the heart and other viscera. The widespread use of basal metabolism equipment indicates the acceptance of this principle by the medical profession.It is well known, however, that increased basal metabolism is not always synonymous with hyperthyroidism. There are a number of conditions which may at one time or another in their course exhibit such elevations in metabolism. This may be noted in heart failure; in some cases of hypertension; during the course of...Bibliography1. TROELL A: Basedow mit niedrigem Grundumsatzwert, Arch. f. klin. Chir., 1932, clxix, 774. MORRIS, R. S.: The thyroid heart with low basal metabolic rate, Am. Jr. Med. Sci., 1931, clxxxi, 297. SCARF, M.: Hyperthyroidism with normal basal metabolic rate (4 cases), Mt. Sinai Hosp. Clin. Soc., 1936. (Unpublished.) Google Scholar2. HURXTHAL LM: Value of blood cholesterol determination in thyroid diseases, Surg. Clin. N. Am., 1933, xiii, 779. EPSTEIN, A. A., and LANDE, H.: Studies on blood lipoids: 1. The relation of cholesterol and protein deficiency to basal metabolism, Arch. Int. Med., 1922, xxx, 563. Google Scholar3. BLUMGART H: Velocity of blood flow in health and disease: velocity of blood flow in man and its relation to other measurements of the circulation, Medicine, 1931, x, 1. BLUMGART, H. L., GARGILL, S. L., and GILLIGAN, D. R.: Studies on the velocity of blood flow. XIII. The circulatory response to thyrotoxicosis, Jr. Clin. Invest., 1930, ix, 69. XIV. The circulation in myxedema with a comparison of blood flow in myxedema and thyrotoxicosis, ibid., p. 91. CrossrefGoogle Scholar4. MACYCLAIBORNEHURXTHAL JWTSLM: Circulation rate in relation to metabolism in thyroid and pituitary states (decholin method), Jr. Clin. Invest., 1936, xv, 37. BOOTHBY, W. M., and RYNEARSON, E. H.: Increase in circulation rate produced by exophthalmic goiter compared with that produced in normal subjects by work, Arch. Int. Med., 1935, lv, 547. ROSENBLUM, H.: Blood flow in patients receiving dinitrophenol, Jr. Am. Med. Assoc., 1935, civ, 1592. CrossrefGoogle Scholar5. FISHBERGHITZIGKING AMWMFH: Measurement of the circulation time with saccharin, Proc. Soc. Exper. Biol. and Med., 1933, xxx, 651. HITZIG, W. M., KING, F. H., and FISHBERG, A. M.: Circulation time in failure in left side of heart, Arch. Int. Med., 1935, lv, 112. CrossrefGoogle Scholar6. GARGILL SL: Use of sodium dehydrocholate as a clinical test of velocity of blood flow, New England Jr. Med., 1933, ccix, 1089. TARR, L., OPPENHEIMER, B. S., and SAGER, R. V.: Circulation time in various clinical conditions determined by use of sodium dehydrocholate, Am. Heart Jr., 1933, viii, 766. CrossrefGoogle Scholar7. GOLDBERG SJ: The use of calcium gluconate as a circulation time test, Am. Jr. Med. Sci., 1936, cxcii, 36. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Philadelphia, Pennsylvania*Received for publication August 24, 1937.From Medical Service No. 2, The Mount Sinai Hospital. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDer jugendliche HochdruckVelocity of Blood Flow in Health and DiseaseKrankheiten der SchilddrüsePreoperative and postoperative treatment of the toxic thyroidOn the Magnesium Sulfate and Ether Circulation Times During Pregnancy**Read at a meeting of the Jefferson Society for Clinical Investigation, Jefferson Medical College, Philadelphia, December 19, 1940.BIBLIOGRAPHIEThe rate of the circulation in the arteries and veins of manMeasurement of circulation time with calcium gluconate in patients receiving digitalis, with electrocardiographic studiesThe use of magnesium sulfate in the measurement of circulation time 1 April 1938Volume 11, Issue 10Page: 1818-1823KeywordsAIDSCardiovascular therapyHeart diseasesHeart failureHypertensionHyperthyroidismMedical services ePublished: 1 December 2008 Issue Published: 1 April 1938 PDF downloadLoading ...

INTERPRETATION OF THE LOWERED BASAL METABOLIC LEVEL*

Of the many metabolic studies developed to aid in the diagnosis of hypothyroidism, basal metabolism remains the most valuable. Even this test with all its simplicity is frequently difficult to interpret when it is found to be persistently low in patients lacking the physical signs of hypothyroidism. With the widespread use of the test in diagnostic procedures, it has become recognized that the accepted range of normal basal metabolic rates of ±10 per cent, established in the earlier years, did not meet all the requirements for accurate clinical interpretation. Likewise it has long been known that many persons with basal rates well below the level of —10 per cent fail to be benefited by thyroid medication. In certain well-defined physical states subnormal basal metabolism is the expected finding. Magnus-Levy (1) in 1906 first called attention to a low rate in marked inanition with the tendency to return toward normal with an improvement in nutrition. Hoskins (2) in a study of 300 cases of schizophrenia found a slight lowering of basal metabolism the rule. Furthermore, a lowered basal metabolic rate in mentally depressed states of appreciable degree is the common finding.

CONGESTIVE HEART FAILURE AND ANGINA PECTORIS

Previous studies of the velocity of the blood flow in man¹have shown that the adequacy of a given velocity of blood flow cannot be decided in absolute terms. It can be evaluated only in relation to the metabolic demands of the particular patient. The best gage of the metabolic needs of the tissues is the basal metabolic rate. Whether or not a patient with heart disease suffers from the signs and symptoms of circulatory insufficiency depends on whether the supply of blood is adequate to the metabolic demands of the tissues. In patients with congestive heart failure and a normal basal metabolic rate, the basal velocity of the blood flow is greatly slowed.²The blood flow may be similarly slowed in patients with the low metabolic rate of myxedema,³but such patients show no clinical symptoms or signs of congestive heart failure. In these patients, therefore,

REGENERATION OF THE THYROID GLAND AND THE PREVENTION OF RECURRENT GOITERS

The prevention of recurrent goiter is an important problem in the treatment of thyroid disease. A review of patients seen complaining of recurrent goiter permits the following classification: (1) pseudorecurrences; (2) recurrence of goiter without symptoms, and (3) recurrence of goiter with symptoms. PSEUDORECURRENCES Pseudorecurrences are generally the result of (1) diagnostic error; (2) symptoms due to permanent lesions, and (3) insufficient operation. This paper will not deal with that group. RECURRENCE WITHOUT SYMPTOMS In the group of recurrences without symptoms are placed those patients who have a definite enlargement of the remaining thyroid without the symptoms of hyperthyroidism and a normal or subnormal basal metabolic rate. The following pathologic processes have been recognized: (1) colloid goiter, which is probably the most common form; (2) diffuse adenomatous goiter, and (3) true adenoma. Patients with a goiter of the true colloid type are relieved by desiccated thyroid. Goiters belonging in the

Iodine and Pulse Rate of Normal Individuals.

The belief exists and the statement has been made that the administration of iodine to normal individuals will produce slowing of the pulse rate. Since no satisfactory information upon this point could be obtained from text-books upon pharmacology and materia medica, it was determined to ascertain the effect on the normal pulse of ingesting the same amount of iodine as we have been administering to patients with Graves' disease. Twelve internes, laboratory workers and physicians, without signs or symptoms of thyroid disease, and with normal basal metabolic rates, volunteered as subjects. There were 4 females and 8 males, 22 to 36 years of age. The pulse rate before arising in the morning was recorded for 10 days to ascertain the normal for each individual. On the next succeeding 10 days Lugol's solution (10 drops) was taken once daily before breakfast. During this period and continuing through another period of 10 days after taking iodine the pulse rate was recorded as in the preliminary period. Records of the mid-day and evening pulse rate were also obtained but these proved to be so variable, depending upon the subjects' activity, that only the mean readings of the morning (basal) pulse are shown in Table I. There was very slight increase in the pulse rate in 7, no change in 3 and a slight decrease in 2 cases. In no individual case was any marked effect noted, neither do the means for each sex show significant change in value. The general tendency of the means for all subjects is toward an increase, but the changes are inconsequential, when tested by the criterion that the difference in two values to bear significance must be greater than 3 times the probable error.

THE BASAL METABOLISM IN BERIBERI

The basal metabolism in beriberi was quite unknown until recent years. A systematic investigation on this problem was first attempted by us. The preliminary report 1 was published at the same time as that of the basal metabolism of the Japanese, reported in a previous article. The conclusion was that the main part of beriberi shows a normal basal metabolic rate, except that in some cases, especially when paralysis or atrophy develops, a marked diminution is also to be observed. Fleming 2 studied the respiratory metabolism and blood chemistry of Filipinos and concluded that between two groups of Filipinos, one with a confirmed diagnosis of beriberi, the other surgical convalescents, no essential differences were found in the basal metabolism rate, respiratory quotient or blood chemistry. As to the vital cause of beriberi, the opinions of various investigators are still diverse. Some workers attribute this disease to the effect of vitamin B deficiency,