Addison's Disease Associated With Thyroid Insufficiency and Atrophy (Schmidt Syndrome)

THE close association of the thyroid and adrenal cortex and the dependence of both organs on the function of the anterior pituitary are known. The exact nature of the interactions of these glands is less well understood. Although many recent publications (1–5) have reported the effect of adrenocortical hormones on thyroid function, little attention has been directed to the effect of adrenal insufficiency on the thyroid gland. The literature also reflects confusion about the metabolic relationships of these glands. Very few cases of Addison's disease with complete clinical appraisal of the status of the thyroid and postmortem examination have been reported since the adoption of the newer diagnostic tests for thyroid function. We have reviewed the literature and re-evaluated all cases of Addison's disease seen at the University Hospital since 1938, giving special attention to clinical and laboratory evidence of thyroid insufficiency. We are reporting 35 cases of Addison's disease, many with extensive studies of thyroid function and wish to comment on a high incidence of thyroid atrophy and hypofunction in these 35 patients.