Use of the TRH Stimulation Test to Assess Long Term Changes of Thyroid Function in an Olympic Athlete.

This case report presents the utility of the thyroid-releasing hormone (TRH) stimulation test for assessing endocrine disease in athletes. On two occasions, 4 years apart (1992 and 1996), a TRH stimulation test was performed to corroborate clinical symptoms and observation. On the first occasion, the patient's symptoms were not attributed to thyroid disease. He was treated for a sinus infection with amoxicillin/clavulanate 500 mg three times per day for 1 wk. On the second occasion, thyroid disease was confirmed and treatment with 100-mu g l-thyroxine was initiated. Baseline screening and TRH stimulation testing were used at both assessment time points. Baseline screen for TSH was 2.2 and 1.2 uUI center dot mL(-1) and stimulated TSH was at 15.2 uUI center dot mL(-1) at 30 min and 30.6 uUI center dot mL(-1) at 45 min for the first (1992) and second (1996) assessment, respectively. Patient was positive on the second visit for antithyroglobulin antibodies at 70 IU center dot mL(-1) (normal, 0-59 IU center dot mL(-1)). Three months postdiagnosis, TSH was 0.66 uIU center dot mL(-1) and the patient was asymptomatic. At the most recent visit, 20 years and 4 months later, no symptomology was reported and TSH was 0.55 uIU center dot mL(-1) A greater understanding of the interaction between stress and end organ function is warranted in occupations undergoing unique stressors.