Elevated Basal and Abnormal Thyrotropin-Releasing Hormone-Induced Thyroid-Stimulating Hormone Secretion in Chronic Alcoholic Men with Liver Disease

Basal levels of serum thyroid-stimulating hormone (TSH). T₃, T₄, free T₃ and free T₄ were measured in 40 chronic alcoholic men and in 31 normal volunteers. Their serum TSH responses to provocative thyrotropin-releasing hormone (TRH) stimulation were then examined serially: in chronic alcoholics, every 5 days for a total of 3 studies; in 25 of the normal volunteers, before and 72 hr after daily ingestion of ethanol (2 cc/kg/day). Basal serum TSH levels were increased in the alcoholic men (3.5 ± 0.2 μU/ml) (mean ± SEM) compared to those of the normal controls (1.7 ± 0.1) (p < 0.01). Both basal serum T₃ and T₄ levels (T₃, 0.89 ± 0.10 ng/ml; T₄, 7.0 ± 0.4 μg/dl) were reduced in the alcoholic men when compared to those of the normal controls (T₃,1.20 ± 0.03 ng/ml; T₄, 8.6 ± 0.3 μg/dl) (p < 0.01 and p < 0.05, respectively). Basal serum free T₃ levels were reduced in the alcoholic men (169 ± 22 pg/dl) compared to the normal controls (380 ± 18) (p < 0.01). In contrast, basal serum free T₄ levels were increased in the alcoholics (4.0 ± 0.2 ng/dl) compared to those of the normal controls (2.9 ± 0.1) (p < 0.01). In response to TRH, the serum TSH levels of the alcoholic men achieved a peak of 13.5 ± 0.9 μU/ml compared to 14.9 ± 0.9 for the normal controls (no significant difference). Despite better nutrition and alcohol abstinence associated with hospitalization for 10 days, no improvement in either the basal levels of TSH, T₃, and T₄ or the TSH responses to provocative TRH was observed in the alcoholic men studied. In normal volunteers, ethanol had no effect on the basal or TRH-stimulated levels of serum TSH and thyroid hormones.