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"Pituitary Reserve" in Myxedema and Thyrotoxicosis

Ann Intern Med. 1963;59(1_Part_1):79-83. doi:10.7326/0003-4819-59-1-79
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The effects of abnormal thyroid function on the elaboration and metabolism of carbon-19 and carbon-21 steroids have been well described (1-3). In hyperthyroidism, the metabolic degradation of these compounds is increased, the adrenal cortex compensating for this by an increased elaboration of these compounds. That this increased turnover may result in a limited pituitary or adrenal reserve in these patients is suggested by the efficacy of corticosteroids in the treatment of thyroid "storm" (4). However, Sagan, Perloff, and DiRaimondo (5) found a normal adrenal response to a single 8-hour intravenous infusion of adrenocorticotropic hormone (ACTH). Other investigators have confirmed this


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