Triiodothyronine supplementation for hypothalamic obesity

• Published in: Metabolism, clinical and experimental Vol. 51; no. 11; pp. 1381 - 1383
• Main Authors: Fernandes, J.K., Klein, M.J., Ater, Joann L., Kuttesch, John F., Vassilopoulou-Sellin, Rena
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2002; Elsevier
• Subjects: Adult; Biological and medical sciences; Brain Neoplasms - complications; Child; Female; Hormones. Endocrine system; Humans; Hypothalamic Diseases - complications; Hypothalamic Diseases - drug therapy; Hypothalamic Diseases - etiology; Male; Medical sciences; Metabolic diseases; Obesity; Obesity - drug therapy; Obesity - etiology; Pharmacology. Drug treatments; Treatment Outcome; Triiodothyronine - therapeutic use; Weight Loss; Endocrinopathy; Human; Obesity; Replacement therapy; Hypothalamic diseases; Treatment efficiency; Nutrition disorder; Weight loss; Chemotherapy; Hypophyseal insufficiency; Pituitary diseases; Thyroid hormone; Bone mineral density; Triiodothyronine; Nutritional status
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1053/meta.2002.35591

Patients with suprasellar lesions develop profound hypothalamic obesity and listlessness with no effective treatment. We added triiodothyronine (T3) supplementation in 3 such patients and present their response. All had previous nutritional counseling without benefit. All were treated for diabetes insipidus (DI) and hypopituitarism; serum free thyroxine (T4) level was normal. A 24-year-old woman (pineal tumor and astrocytoma) had weight gain (4.7 kg/yr for 3 years), cold intolerance, fatigue, dry skin, and constipation; after T3, she lost 14 kg over 27 months and reported overall improvement. Her bone mineral density also improved. A 10.6-year-old boy (optic glioma) was gaining 6 kg/yr for 4 years; after T3 supplement, he lost 4.3 kg over 11 months. A 12-year-old girl (mixed germ cell tumor) had weight gain (8.3 kg/yr for 3 years) and listlessness; after T3, she lost 8.1 kg over 16 months and had improved alertness. All patients were asymptomatic despite supraphysiologic T3 levels. We suggest that T3 may serve as a simple and effective supplement, which can promote weight loss and improve the well being of these patients with hypothalamic obesity.