Growth and thyroid function in children treated with growth hormone

Pirazzoli, P; Cacciarl, Emanuele; Mandini, M; Sganga, T; Capelli, M.; Cicognani, Alessandro; Gualandi, Stefano

doi:10.1016/s0022-3476(05)81190-4

Cited by 49 publications

(48 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An increase in serum T3 and a further decrease in plasma TSHwere demonstrated in the course. It might be possible that GHand subsequently the normalized plasma IGF-I stimulated the peripheral conversion of T4 to T3 (8) and that the increased active hormone levels available thereby inhibited TSHsecretion from the pituitary gland. It is generally agreed that GHreplacement therapy is beneficial for adult patients with GHdeficiency.…”

Section: Discussionmentioning

confidence: 99%

Isolated Adrenocorticotropic Hormone Deficiency Associated with Growth Hormone Deficiency and Empty Sella.

et al. 1995

View full text Add to dashboard Cite

A 38-year-old man had an acute onset of consciousness loss, pyrexia and hyponatremia. Plasma Adrenocorticotropic Hormone (ACTH)and cortisol levels were low. Plasma ACTHfailed to respond to corticotropin-releasing hormone (CRH)and insulin-induced hypoglycemia whereas i.m. injection of ACTH-Zraised plasma cortisol. Plasma insulin-like growth factor-I (IGF-I) and urine growth hormone (GH) concentrations were also low and plasma thyroid-stimulating hormone(TSH) level was rather elevated. Plasma IGF-I and TSHlevels were not completely normalized by glucocorticoid (GC) replacement alone although plasma GHresponses to pharmacological stimuli were normalized. The GCreplacement in combination with daily s.c. injection of recombinant human GH(rhGH) not only normalized plasma IGF-I and IGFBP-3 levels, but also further lowered the plasma TSHlevel, possibly due to an increased T4/T3 conversion, which resulted in a beneficial change in body composition. (Internal Medicine 34: 688-691, 1995)

show abstract

Section: Discussionmentioning

confidence: 99%

Isolated Adrenocorticotropic Hormone Deficiency Associated with Growth Hormone Deficiency and Empty Sella.

et al. 1995

View full text Add to dashboard Cite

show abstract

“…The latter findings led the authors to conclude that observations made in previous studies could represent an unmasking by GH of incipient central hypothyroidism or, alternatively, relate to the fact that T 4 levels normally decline during childhood. Finally, five studies in hypopituitary patients revealed a decline in T 4 concomitant with an increase in triiodothyronine (T 3 ) during GH therapy for between 2 weeks and 18 months [6, 7, 8, 9, 10]. Rezvani et al [9]also reported a decline in reverse T 3 (rT 3 ) levels, which, put together, suggested a GH-induced enhancement of extrathyroidal T 4 to T 3 conversion.…”

Section: Thyroid Hormonesmentioning

confidence: 99%

Impact of Growth Hormone Administration on Other Hormonal Axes

et al. 1999

View full text Add to dashboard Cite

Growth hormone regulates several other hormonal systems and vice versa. The present review focusses on the effect of GH administration in adults on selected hormonal systems. Growth hormone treatment has been linked to development of central hypothyroidism in hypopituitary children. We now know that GH enhances the extra-thyroidal conversion of T₄ to T₃. Lowering of T₄ during GH treatment therefore reflects biochemical unmasking of subclinical central hypothyroidism. In normal adults GH administration does not affect the pituitary-gonadal axis. There is, however, evidence to suggest that GH substitution in hypopituitary adults enhances peripheral actions of sex steroids (males) and stimulates gonadal function (females). Both increased, unchanged and reduced basal and ACTH stimulated glucocorticoid levels have been reported during GH treatment. Several groups have recorded reduced levels of cortisol binding globulin with unchanged free cortisol concentrations. Regular assessment of thyroid and glucocorticoid status during GH substitution in GH-deficient patients is recommended.

show abstract

“…It is well-known that GH administration modulates serum levels of T 3 and T 4 due to enhance peripheral conversion of T 4 to T 3 in both healthy volunteers [1, 2]and in GH-deficient (GHD) patients [3, 4, 5, 6]. IGF-I administration has been shown to suppress the TSH release by increased release of somatostatin, but without influence on the peripheral thyroid hormone metabolism in healthy males [7].…”

Section: Introductionmentioning

confidence: 99%

Effect of Growth Hormone Replacement Therapy on Pituitary Hormone Secretion and Hormone Replacement Therapies in GHD Adults

Hubina¹,

Mersebach

Rasmussen

et al. 2004

Horm Res Paediatr

View full text Add to dashboard Cite

Objective: We tested the impact of commencement of GH replacement therapy in GH-deficient (GHD) adults on the circulating levels of other anterior pituitary and peripheral hormones and the need for re-evaluation of other hormone replacement therapies, especially the need for dose changes. Methods: 22 GHD patients were investigated in a double-blind randomized study and 90 GHD patients in an open study at baseline and after 6 and 12 months of GH replacement therapy. Results: In the placebo-controlled trial, the FT₃ levels increased after 6 months in the GH-treated group, and in the open study the FT₃ levels tended to increase. Other hormone concentrations did not change in either part of the study. Four patients required an increase in thyroxine dose, while 2 patients needed dose reduction. One originally euthyroid patient required thyroxine replacement. Two patients with originally conserved pituitary-adrenal function developed ACTH insufficiency. The hydrocortisone dose was increased in 1 and decreased in 1 of the 66 patients with secondary hypocortisolism. None of the females required any adjustment of sex hormone replacement therapy. Two of 37 males needed dose increase of testosterone, while 1 needed dose reduction. Conclusion: GH replacement therapy required dose adjustments regarding other hormone replacement therapies in 12.2% (n = 11), while initiation of new hormone replacement was performed in 3.3% (n = 3) of the 90 patients during the 1-year follow-up. Monitoring of pituitary hormone axes is advisable after commencement of GH replacement therapy, since changes of hormone replacement therapy was observed in a small but clinically significant number of patients.

show abstract

Growth and thyroid function in children treated with growth hormone

Cited by 49 publications

References 15 publications

Isolated Adrenocorticotropic Hormone Deficiency Associated with Growth Hormone Deficiency and Empty Sella.

Isolated Adrenocorticotropic Hormone Deficiency Associated with Growth Hormone Deficiency and Empty Sella.

Impact of Growth Hormone Administration on Other Hormonal Axes

Effect of Growth Hormone Replacement Therapy on Pituitary Hormone Secretion and Hormone Replacement Therapies in GHD Adults

Contact Info

Product

Resources

About