A question arises concerning the effects of GH on treatment
of hypothyroidism. My wife started GH in either 2003
or 2004 to compensate for decreased physical ability due to
sustained intractable pain. She was recently diagnosed with
primary hypothyroidism based on very high TSH ("thyroid
stimulating hormone") levels.

Medication has brought the TSH down to normal but the T4 and
T3 remain low, and are actually lower than before.

Since TBG ("thyroid binding globulin") is decreased by GH,
and is the main transport of 80% of thyroid hormone, is there
a negative implication of GH use at this point?

Similarly, is there an effect on the lab values which needs to
be taken into account?

Thanks,

Dr. Craig Dvorkin, DC




Ellis: Hello Dr. Dvorkin,

I am unable to answer your question, but I have other questions
to ask you: What happened to the PAIN and decreased physical
ability for which your wife took HGH in 2003 or 2004? Did her
physical ability improve, and/or did her pain decrease?

Also... did she have hypothyroidism from 2003 (or 2004) until
2009, or is this something that developed recently?

My gut feeling is that if this is a condition that she has
developed recently, it is not due to growth hormone...

And in any case, if growth hormone in any way helped her physical
ability or lessened the pain, then you should not wonder about
if growth hormone decreases thyroid binding globulin, and treat
her low thyroid levels with T3 or T4 or Armour thyroid.

The following is found in books of interpretation of blood tests:

Reduced T4 levels can be caused by:

* anabolic steroids

* androgens

* antithyroid drugs

* cretinism

* hypothyroidism

* kidney failure

* lithium (Lithane, Lithonate)

* myxedema

* phenytoin

* propranolol

Low T3 levels may be a symptom of:

* acute or chronic illness

* hypothyroidism

* kidney or liver disease

* starvation

Decreased T3 levels can also be caused by using:

* anabolic steroids

* androgens

* phenytoin

* propranolol

* reserpine (Serpasil)

* salicylates in high doses

TBG

TBG levels, normally high during pregnancy, are also high in
newborns. Elevated TBG levels can also be symptoms of:

* acute hepatitis

* acute intermittent porphyria

* hypothyroidism

* inherited thyroid hormone abnormality

TBG levels can also become high by using:

* anabolic steroids

* birth control pills

* anti-thyroid agents

* clofibrate

* estrogen therapy

* phenytoin

* salicylates in high doses

* thiazides

* thyroid medications

* warfarin (Coumadin)

TBG levels can be raised or lowered by inherited liver disease whose
cause is unknown.

Low TBG levels can be a symptom of:

* acromegaly

* acute hepatitis or other acute illness

* hyperthyroidism

* kidney disease

* malnutrition

* marked hypoproteinemia

* uncompensated acidosis


But I am not a doctor and I am not an expert on thyroid, so
don't take what I say as the final word.

Doctors or anybody else who can answer this question, please do:
should Dr. Dvorkin's wife STOP taking growth hormone, because
perhaps it is causing her hypo-thyroidism because perhaps it
lowers thyroid binding globulin?

Thanks for writing. - Ellis