THE THYROTROPIN-RELEASING-HORMONE STIMULATION TEST IN ALCOHOLISM

The mechanism for a blunted thyroid stimulating hormone (TSH) response to thyrotropin releasing hormone (TRH) in alcoholics is not known. We performed a combined TRH and gonadoliberin stimulation test on three well-defined groups of nondepressed alcoholic men. Group A comprised p atients with acute withdrawal symptoms (n = 28), group B patients abst inent for 5-8 weeks (n = 29) and group C patients who had been abstine nt for >2 years (n = 16). Twenty-two healthy male volunteers were used for comparison. A blunted TSH response to TRH (delta TSH < 5 mu U/1) occurred only in groups A (39%) and B (17%). In group A delta TSH show ed a significant negative correlation with the severity of withdrawal symptoms and a significant positive correlation with serum magnesium l evels. In group B, patients with a family history of alcoholism had si gnificantly lower delta TSH levels than those without such a family hi story. Groups did not differ with respect to basal and delta prolactin , and TSH responses were not significantly associated with vitamin def iciency, cortisol levels or free thyroid hormone levels. We conclude t hat TRH stimulation test blunting appears to be related to factors ope rating in the withdrawal state and improves with continued abstinence. A possible role of genetic factors and serum magnesium needs to be fu rther explored.