Influence of Thyroid Status on Dopaminergic Inhibition of Thyrotropin and Prolactin Secretion: Evidence for an Additional Feedback Mechanism in the Control of Thyroid Hormone Secretion

Abstract

Serum TSH [thyrotropin] and PRL [prolactin] concentrations were measured after the randomized oral administration of either metoclopramide, L-dopa or placebo on 3 consecutive days to 5 patients with overt primary hypothyroidism (low serum total T [thyroxine] and raised serum TSH) and to 5 patients with subclinical hypothyroidism (normal serum total T4 and raised serum TSH). In both groups there was a rise in serum TSH and PRL concentrations after metoclopramide and a fall after L-dopa when compared with the effect of the placebo. The rise in serum TSH and PRL concentrations was significantly greater in patients with subclinical hypothyroidism compared to that in patients with overt hypothyroidism. It was not possible to show any significant difference in the degree of fall of these pituitary hormones after L-dopa administration in the 2 groups. In addition to the established negative feedback of thyroid hormones at the level of anterior pituitary thyrotropes, apparently there is a previously unrecognized effect of thyroid hormones at the hypothalamus, resulting in increased dopaminergic inhibition of TSH release. Stimulation of hypothalamic dopamine by thyroid hormones also inhibits PRL secretion.