We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Acute Hemodynamic Effects of Levothyroxine Loading in Critically Ill Hypothyroid Patients

Elaine M. Kaptein, MD; Herminia Quion-Verde, MD; Robert S. Swinney, MD; Pujitha M. Egodage, MD; Shaul G. Massry, MD
Arch Intern Med. 1986;146(4):662-666. doi:10.1001/archinte.1986.00360160064008.
Text Size: A A A
Published online


• To evaluate the acute cardiovascular effects of high-dose levothyroxine sodium therapy, the hemodynamic findings in eight critically ill hypothyroid patients treated with high-dose levothyroxine were compared with those in two critically ill hypothyroid and nine critically ill euthyroid patients not receiving this therapy. The initial cardiac index was significantly lower in the hypothyroid group; all other hemodynamic values were similar to those of the euthyroid patients. Following levothyroxine loading, the free thyroxine index increased to normal while the free triiodothyronine index was unchanged; all patients had a significant rise in cardiac index but no consistent changes in the other hemodynamic values. Cardiac index correlated positively with heart rate (three patients) and/ or stroke volume index (six patients). Increases in stroke volume index correlated with decreases in systemic vascular resistance (five patients), but not with increases in pulmonary artery wedge pressure. No consistent patterns of hemodynamic changes were observed in the untreated hypothyroid or the euthyroid patients.

(Arch Intern Med 1986;146:662-666)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

12 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.