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January 1976

Propranolol as Primary Therapy for Thyrotoxicosis: Results of a Long-Term Prospective Study

Author Affiliations


From the Division of Endocrinology and Metabolism, Ohio State University Hospitals, Columbus (Drs. Mazzaferri and Reynolds); the divisions of endocrinology and metabolism (Dr. Young) and cardiology (Dr. Thomas), Wilford Hall USAF Medical Center, San Antonio, Texas; and the Division of Cardiology, Baltimore Veterans Administration Hospital, Baltimore (Dr. Parisi).

Arch Intern Med. 1976;136(1):50-56. doi:10.1001/archinte.1976.03630010034006

It has been suggested that propranolol hydrochloride alone is effective in the treatment of thyrotoxicosis. To test this hypothesis, eight mildly thyrotoxic individuals were prospectively studied for an average of eight months, during which propranolol alone was administered and thyroid function tests, cardiac systolic time intervals, and body densities were sequentially measured. Two patients became euthyroid. The others had adequate but incomplete symptomatic control. Weight loss was not corrected, but no changes in lean body mass were induced. The augmented myocardial contractility of thyrotoxicosis, as determined by systolic time intervals, improved but failed to return completely to normal. Thus, systolic time intervals are a practical means of following the peripheral response to chronic beta-adrenergic blockade in thyrotoxic patients. However, these observations do not support the use of propranolol alone as the first choice of therapy for thyrotoxicosis.

(Arch Intern Med 136:50-56, 1976)

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