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Hypothyroid subjects given a constant dose of thyroxine (T4) show both an increase in serum thyrotrophin (TSH) of approximately 50% and a decline of serum T4 by approximately 15% during the winter months. Euthyroid subjects who are older than 41 years of age show an increase of approximately 30% in serum TSH during the winter months without a change in T4. Young euthyroid subjects, between the ages of 19 and 41 years, show neither a circannual pattern of TSH nor T4 but have an increase in triiodothyronine (T3) plasma clearance rate and production rate of approximately 30% during the winter seasons. Additionally, young subjects living for greater than 5 months in Antarctica show a doubling in T3 plasma clearance rate and production rate, as well as elevations of approximately 30-50% in TSH and small declines in T4. Repeated exposure to cold air has recently been reported to induce declines in serum T3, and T4 and increases in T3 clearance and production rate, thus linking a possible physiological stimulus to these seasonal observations. This collection of studies from several laboratories supports the concept that T3 kinetic changes have a seasonal dependence and that cold exposure provides one possible mechanism. As the subjects age, have a fixed thyroid hormone dosage for hypothyroxinemia, or spend an extended number of months in polar conditions, a reflex TSH rise occurs. This rise in TSH signals a hypothalamic-pituitary hypothyroxinemia whose clinical significance is unknown.

Cold exposure, activity and energy deficit have been associated with changes in body composition and/or changes in serum thyroid hormones. Because these conditions are present during the Iditarod Sled Dog Race, 10 volunteer participants were studied before and after the race. Body composition, total thyroxine (TT4), free thyroxine (FT4), total triiodothyronine (TT3), and free triiodothyronine (FT) levels were determined. There was a significant decrease in body weight (p < 0.05) and a decrease in body fat (p < 0.01). There were no significant changes in TT4, FT4, TT3 or FT3. On the basis of this study, it can be concluded that the strenuous activity of the Iditarod mitigates against the classic perturbation in thyroid axis brought on by the hypocaloric state.

Whole blood hematocrit (HCT) decreases during multiple exposures to cold air. To better understand this finding, we have analyzed hematological profiles in 27 normal adult men exposed repeatedly to cold air in one of two experimental protocols. Experiment I was a cold air acclimatization study (CAA) conducted with two groups of 8 men in each group before, during, and after 80 separate 30-minute cold (4 degrees C) air exposures. As part of a metabolic study, half of the men received placebo daily (n = 8), and the other half received an oral daily maintenance dose of the thyroid hormone triiodothyronine (T3) (30 micrograms/day). Blood was analyzed prior to and after every 20 cold exposures. Both groups reacted similarly. When compared with basal conditions, hematocrit (HCT) and erythrocyte counts (RBC) were decreased (p less than 0.05); mean corpuscular hemoglobin concentration (MCHC) and plasma volume (PV) were increased with cold exposure (p less than 0.05). Hemoglobin (Hb), leukocyte counts (WBC), and mean corpuscular volume (MCV) were unchanged. Experiment II was carried out with 9 military volunteers during extended arctic winter field operations (EAO) in Utah and Alaska. Blood was analyzed prior to and after completion of EAO. A changing hematological profile similar to that in the CAA protocol was found. Hematocrit and RBC were decreased (p less than 0.02); MCHC and PV were increased (p less than 0.02). Hemoglobin, WBC, and MCV were unchanged. In addition, there was a negative correlation between HCT and the absolute reticulocyte count in this second experiment. It would appear that in instances of cold stress, whether induced or naturally occurring, certain blood cellular elements respond in a similar adaptive manner.