Objectives: To compare standard laboratory analytical methods with measurement of basal metabolic temperature in cases of hypothyroidism arising posttraumatically.
Setting: Private medical office.
Subjects: One hundred and one consecutive status post-whiplash trauma patients.
Design: All subjects were evaluated with standard laboratory tests (T3RU, T4, FT4I, TSH) for thyroid function. Ninety-four were also evaluated with the newer fluorescence-activated microsphere assay test (FAMA) and basal metabolic temperature (BMT) was measured in all. Correlations were investigated between BMT, age, gender, standard laboratory values and the FAMA test. The differences between low and high BMT vs. normal and abnormal standard laboratory values and the differences between normal and abnormal standard laboratory values vs. normal and elevated FAMA test results were also investigated.
Results: In 86.4%, the BMTs were below normal. Of this subgroup, 30% had abnormal standard laboratory values. Of the 13% whose BMT was within the normal range, 33% had abnormal standard laboratory values and 66% had increased FAMA titers. Statistically significant correlation was found between BMT and T3RU (p = .05), whereas the correlation between BMT and T4 was somewhat weaker (p = .07). Correlations between BMT and all other laboratory indices failed to reach significance. The laboratory abnormalities observed in this group of subjects were atypical for common types of hypothyroidism. A significant portion of our posttraumatic hypothyroid group (30%) were not identified with either standard laboratory tests or the FAMA test-a group we referred to as lab-normal.
Conclusions: Measurement of BMT seems to be a sensitive screening test, in combination with laboratory analysis, for the hypothyroidism seen after whiplash trauma. Whiplash seems to result in a form of hypothyroidism suggesting direct injury to central tissues.