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Thyroid Hormone Treatment and Uric Acid Level

Last Updated: · Doctors


Dear Doctor I have a patient with benign thyroid cyst on suppressive therapy with 150 micrograms thyroxine . H e r thyroid function tests on this are : Free T 4 23.2pmol/l range10-25 freeT3 6.8pmol/l range 3.3-7.2 S-TSH <0.01 0.2-0.4 Her uric acid is very low at 86micromols/l, range 140-390. She also has a hip bursitis and shoulder capsulitis, but ESR is normal, RF normal, and ANF normal. Her diet is apparently normal. Using a MIRENA coil . Is there any relation of the low uric acid to the thyroid treatment


Dr Tom Scade, MbChBBSC(Hons) FRCP(G) MRCGP(UK)
Emirates Clinic
PO Box 26777, Dubai


There is no description that I can find of subnormal serum uric acid associated with thyroid hormone excess. There is a useful section on hypouricemia in the Harrison text, 14th Edn, p2165. Can you be sure that none of the medications used for the shoulder complaint have a uricosuric component ? One other comment. I wonder about the wisdom of using suppressive T4 therapy in a woman who may be at risk of osteoporosis, when the benefit of such therapy in managing benign cysts is less than convincing. Subclinical thyrotoxicosis as a result of suppressive T4 certainly seems to decrease bone density (see Wesche et al J Clin Endocrinol Metab 2001; 86:998-1005)


Jim Stockigt