Triiodothyronine supplementation for hypothalamic obesity

Patients with suprasellar lesions develop profound hypothalamic obesity and listlessness with no effective treatment. We added triiodothyronine (T-3) supplementation in 3 such patients and present their response. All had previous nutritional counseling without benefit. All were treated for diabetes insipidus (DI) and hypopituitarism; serum free thyroxine (T-4) level was normal. A 24-year-old woman (pineal tumor and astrocytoma) had weight gain (4.7 kg/yr for 3 years), cold intolerance, fatigue, dry skin, and constipation; after T-3, She lost 14 kg over 27 months and reported overall improvement. Her bone mineral density also improved. A 10.6-year-old boy (optic glioma) was gaining 6 kg/yr for 4 years; after T-3 supplement, he lost 4.3 kg over 11 months. A 12-year-old girl (mixed germ cell tumor) had weight gain (8.3 kg/yr for 3 years) and listlessness; after T-3, she lost 8.1 kg over 16 months and had improved alertness. All patients were asymptomatic despite supraphysiologic T-3 levels. We suggest that T-3 may serve as a simple and effective supplement, which can promote weight loss and improve the well being of these patients with hypothalamic obesity. Copyright 2002, Elsevier Science (USA). All rights reserved.