The interaction between growth hormone and the thyroid axis in hypopituitary patients: Interaction between growth hormone and thyroid axis
Open accessAbstract
Alterations in the hypothalamo-pituitary-thyroid axis have been reported following growth hormone (GH) administration in both adults and children with and without growth hormone deficiency. Reductions in serum free thyroxine (T4), increased tri-iodothyronine (T3) with or without a reduction in serum thyroid-stimulating hormone secretion have been reported following GH replacement, but there are wide inconsistencies in the literature about these perturbations. The clinical significance of these changes in thyroid function remains uncertain. Some authors report the changes are transient and revert to normal after a few months or longer. However, in adult hypopituitary patients, GH replacement has been reported to unmask central hypothyroidism biochemically in 36-47% of apparently euthyroid patients, necessitating thyroxine replacement and resulting in an attenuation of the benefit of GH replacement on quality of life in those who became biochemically hypothyroid after GH replacement. The group at highest risk are those with organic pituitary disease or multiple pituitary hormone deficiencies. It is therefore prudent to monitor thyroid function in hypopituitary patients starting GH therapy to identify those who will develop clinical and biochemical features of central hypothyroidism, thus facilitating optimal and timely replacement.
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The hypothalamic-pituitary-thyroid axis influences growth hormone dynamics, with altered growth hormone and IGF-1 secretion occurring in hypothyroidism.
“The hypothalamic-pituitary-thyroid axis also influences GH dynamics, with altered GH and IGF-1 secretion occurring in hypothyroidism (34).”
From Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [34]
Initiation of GH replacement may unmask latent central hypothyroidism.
“Initiation of GH replacement may unmask not only latent central hypothyroidism, but also latent hypoadrenalism (Behan et al., 2011;Filipsson and Johannsson, 2009;Toogood et al., 1998).”
From The hypothalamus-pituitary-thyroid (HPT)-axis and its role in physiology and pathophysiology of other hypothalamus-pituitary functions (2021) · cites this paper as Behan et al., 2011
Initiation of GH replacement may unmask latent hypoadrenalism.
“Initiation of GH replacement may unmask not only latent central hypothyroidism, but also latent hypoadrenalism (Behan et al., 2011;Filipsson and Johannsson, 2009;Toogood et al., 1998).”
From The hypothalamus-pituitary-thyroid (HPT)-axis and its role in physiology and pathophysiology of other hypothalamus-pituitary functions (2021) · cites this paper as Behan et al., 2011
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Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline
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- Authors
- Behan, L. A., Monson, J. P., & Agha, A.
- Affiliations
- Beaumont Hospital (IE)
- St Bartholomew's Hospital (GB)
- Corresponding author
- Agha, Amar
- ORCID
- Behan, Lucy Ann
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2011-02-08
- Volume
- 74
- Issue
- 3
- Pages
- 281-288
- ISSN
- 0300-0664 (ISSN-L)
- OpenAlex
- W1552278202
- Cited by
- 53
- References
- 71
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 4 · 2022: 4 · 2021: 9 · 2020: 5 · 2019: 2 · 2018: 6 · 2017: 3 · 2016: 4 · 2015: 2 · 2014: 3 · 2013: 4 · 2012: 2
- FWCI
- 1.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Lenus, The Irish Health Repository (Dr Steevens Hospital Library) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Keywords
- growth hormone therapy, hypothalamic-pituitary-thyroid axis, hypopituitarism, central hypothyroidism, thyroid-stimulating hormone, free thyroxine, triiodothyronine, multiple pituitary hormone deficiency, thyroid function monitoring, thyroxine replacement, quality of life
- MeSH terms
- Adult, Child, Humans, Hypopituitarism, Hypothyroidism, Thyroid Gland, Thyroxine, Triiodothyronine, Human Growth Hormone, Hormone Replacement Therapy
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