Abstract
Pituitary-thyroid changes have been reported during recombinant human growth hormone (rhGH) therapy at the dose commonly used in pre-puberty. We have previously demonstrated that low doses of rhGH were able to normalize body composition and both cardiac structure and function in growth hormone deficient adults (GHDA), without causing any of the side effects described when the GHDA were treated with doses commonly employed in the GHD children. The aim of this study was to evaluate the behaviour of pituitary-thyroid parameters in GHDA undergoing such a low dose of rhGH treatment. We studied 9 (2 females and 7 males, 25–34 yr) GHDA, 7 congenital and 2 acquired GH deficiency, before, during and after a 12-month rhGH treatment at dose of 10 μg/kg/day (=70 μg/kg/week) divided in 3 injections, administered sc at 20:00 h on Monday, Wednesday and Friday, respectively. Thyroid deficiency and other hormonal deficiencies, when present, had been adequately corrected with replacement therapy. Serum IGF1, T3, T4, free-T3, free-T4, TSH, reverse-T3, T3/T4 and FT3/FT4 ratios were studied basally, every 3 months during the 12-month rhGH treatment and every 3 months for a period of 12 months off therapy. Analysis of variance (ANOVA) was performed as statistical method. All parameters (except IGF1) did not show any variation during and after rhGH treatment at low doses. The alterations of T3 and T4 metabolism, in the sense of a T3 increase and a T4 reduction, caused sometimes by rhGH treatment, could be due to the higher doses used and therefore should be considered another side effect, like artrhalgia, fluid retention, carpal tunnel syndrome, etc.
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Oliner L., Ballantine J.J. Effect of human growth hormone on thyroidal secretion, radiothyroxine turnover and transport in man. J. Clin. Endocrinol. Metab. 28: 603, 1968.
Sack J., DeLamater P. Hypothyroidism after growth hormone therapy. Pediatrics 52: 625, 1973.
Porter B.A., Refetoff S., Rosenfield R.L., De Groot L.J., Fang V.S., Stark V. Abnormal thyroxine metabolism in hyposomatotrophic dwarfism and inhibition of responsiveness to TRH during GH therapy. Pediatrics 51: 668, 1973.
Lippe B.M., Van Herle A.J., La Franchi S.H., Uller R.P., Lavin N., Kaplan S.A. Reversible hypothyroidism in growth hormone-deficient children treated with human growth hormone. J. Clin. Endocrinol. Metab. 40: 612, 1975.
Sato T., Suzuki Y., Taketani T., Ishiguro K., Masuyama T., Takata I., Sano M., Kawashima H., Koizumi S., Nakajima H. Enhanced peripheral conversion of thyroxine to triiodothyronine during hGH therapy -in GH deficient children. J. Clin. Endocrinol. Metab. 45: 324, 1976.
Rosenbloom A.L., Riley W.J., Silverstein J.H., Garnica A.D., Netzloff M.L., Weber F.T. Low dose single weekly -injections of growth hormone: response during first year of therapy of hypopituitarism. Pediatrics 66: 272, 1980.
Demura R., Yamaguchi H., Wakabayashi I., Demura H., Shizume K. The effect of hGH on hypothalamic-pituitary-thyroid function in patients with pituitary dwarfism. Acta Endocrinol. (Copenh.) 93: 13, 1980.
Rezvani I., DiGeorge A.M., Dowshen S.A., Bourdony C.J. Action of human growth hormone (hGH) on extrathyroidal conversion of thyroxine (T4) to triiodothyronine (T3) in children with hypopituitarism. Pediatr. Res. 15: 6, 1981.
Stahnke N., Koehn H. Replacement therapy in hypothalamus-pituitary insufficiency: management in the adolescent. Horm. Res. 33: 38, 1990.
Pirazzoli P., Cacciari E., Mandini M., Sganga T., Capelli M., Cicognani A., Gualandi S. Growth and thyroid function in children treated with growth hormone. J. Pediatr. 121: 210, 1991.
Sacco V., Maioli A., Citro G., Galasso R., Vinci M.L., Zampino A. Effetti del trattamento con GH-biosintetico sulla funzione tiroidea in soggetti con deficit isolato di GH. Minerva Endocrinol. 17: 13, 1992.
Grunfeld C., Sherman B.M., Cavalieri R.R. The acute effects of human growth hormone administration on thyroid function in normal men. J. Clin. Endocrinol. Metab. 67: 1111, 1988.
Ho K.J., Weissemberg A.J., Stuart M.C., Day R.O., Lazarus L. The pharmacokinetics, safety and endocrine effects of authentic biosynthetic human growth hormone in normal subjects. Clin. Endocrinol. (Oxf.) 30: 335, 1989.
Brixen K., Nielsen H.K., Bouillon R., Flyvbjerg A., Mosekilde L. Effects of short-term growth hormone treatment on PTH, calcitriol, thyroid hormones, insulin and glucagon. Acta Endocrinol. (Copenh.) 127: 331, 1992.
Jorgensen J.O.L., Moller J., Skakkebaek N.E., Weeke J., Christiansen J.S. Thyroid function during growth hormone therapy. Horm. Res. 38: 63, 1992.
Moeller J., Jorgensen J.O.L., Moller N., Christiansen J.S., Weeke J. Effects of growth hormone administration on fuel oxidation and thyroid function in normal man. Metabolism 41: 728, 1992.
Deyssig R., Frisch H., Blum W.F., Waldhor T. Effect of growth hormone treatment on hormonal parameters, body composition and strength in athletes. Acta Endocrinol. (Copenh.) 127: 331, 1993.
Jorgensen J.O.L., Pedersen S.A., Thuesen L., Jorgensen J., Ingemann-Hansen T., Christiansen J.S. Beneficial effects of growth hormone treatment in CH-deficient adults. Lancet. 1: 1221, 1989.
Salomon F., Cuneo R.C., Hesp R., Sonksen P.H. The effects of treatment with recombinant human growth hormone on body composition and metabolism in adults with growth hormone deficiency. N. Engl. J. Med. 321: 1797, 1989.
Binnerts O., Swart G.R., Wilson J.H.P., Hoogerbrugge N., Pols H.A.P., Birkenhager J.C., Lamberts S.W.J. The effect of growth hormone administration in growth hormone deficient adults on bone, protein, carbohydrate and lipid homeostatis, as well as on body composition. Clin. Endocrinol. (Oxf.) 37: 79, 1992.
Bengtsson B-A., Staffan E., Lonn L., Kvist H., Stokland A., Lindstedt G., Bosaeus I., Tolli J., Sjostrom L., Isaksson O.G.P. Treatment of adults with growth hormone (GH) deficiency with recombinant human GH. J. Clin. Endocrinol. Metab. 76: 309, 1993.
Jorgensen J.O.L., Moller J., Laursen T., Orskov H., Christiansen J.S., Weeke J. Growth hormone administration stimulates energy expenditure and extrathyroidal conversion of thyroxine to triiodothyronine in a dose-dependent manner and suppresses circadian thyrotrophin levels: studies in GH-deficient adults. Clin. Endocrinol. (Oxf.) 41: 609, 1994.
Stenlof K., Sjostrom L., Lonn L., Bosaeus I., Kvist H., Tolli J., Lindstedt G., Bengtsson B.-A. Effects of recombinant human growth hormone on basal metabolic rate in adults with pituitary deficiency. Metabolism 44: 67, 1995.
Amato G., Carella C., Fazio S., La Montagna G., Cittadini A., Sabatini D., Marciano-Mone C., Sacca L., Bellastella A. Body composition, bone metabolism and heart structure and function in growth hormone (GH)-deficient adults before and after GH replacement therapy at low doses. J. Clin. Endocrinol. Metab. 77: 1671, 1993.
Cuneo R.C., Salomon F., McGauley G.A., Sonksen P.H. The growth hormone deficiency syndrome in adults. Clin. Endocrinol. (Oxf.) 37: 387, 1992.
Jenkins D., Stewart P.M. Advances in medical therapy for pituitary disease: treating patients with growth hormone excess and deficiency. J. Clin. Pharmacol Ther. 18: 155, 1993.
Klinger B., Ionesco A., Anin S., Laron Z. Effects of insulin-like growth factor I on the thyroid axis in patients with Laron-type dwarfism and healthy subjects. Acta Endocrinol. (Copenh.) 127: 515, 1992.
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Amato, G., Izzo, G., Salzano, I. et al. Recombinant human growth hormone treatment at low doses does not significantly change thyroid function in growth hormone deficient adults. J Endocrinol Invest 19, 563–566 (1996). https://doi.org/10.1007/BF03349017
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DOI: https://doi.org/10.1007/BF03349017