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Exp Clin Endocrinol Diabetes 2000; Vol. 108(4): 282-289
DOI: 10.1055/s-2000-7756
Articles

© Johann Ambrosius Barth

The influence of hyperthyroidism on the hypothalamic-pituitary-gonadal axis

S. Zähringer 1 , A. Tomova 2 , K. von Werder 3 , G. Brabant 4 , P. Kumanov 2 [*] , J. Schopohl 1
  • 1 Medizinische Klinik, Innenstadt, University of Munich, Germany
  • 2 Clinical Center of Endocrinology, Medical University, Sofia, Bulgaria
  • 3 Schloßparkklinik, Humboldt Universität Berlin, Germany
  • 4 Medizinische Hochschule Hannover, Germany
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Publication History

Publication Date:
31 December 2000 (online)

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Summary:

We have investigated the function of the hypothalamic-pituitary-gonadal (H-P-G)-axis in patients with severe, untreated Graves' disease. We studied 7 male and 6 female healthy volunteers, and 7 male and 7 female patients with Graves' disease. Hormone profiles were developed by blood sampling every 10 min for an 8 hour period. In women this was done in the early follicular phase of menstrual cycle. LH-, FSH-, and PRL levels were measured using immunoradiometric assays and testosterone (T), estradiol (E2), sex-hormone binding globulin (SHBG), and progesterone (P) were measured with standard assays. The pulsatility of LH, FSH and PRL was calculated using the programmes Pulsar, Cluster and Desade. The temporal relationship of plasma LH, FSH, and PRL pulses was also investigated using specific concordance analysis. Data were evaluated by means of non-parametric statistics. LH-secretion was increased in all hyperthyroid patients, while FSH-secretion was increased in hyperthyroid men only. Pulsatile characteristics of LH- and FSH-secretion (frequency, peak shape) in patients were not different from controls. No change in PRL-secretion was shown. Significant copulsatility occurred between LH and FSH, and LH and PRL. This was more pronounced in hyperthyroid than in healthy study subjects. Plasma levels of steroid hormones and sex-hormone-binding globulin were significantly (p < 0.005) increased in hyperthyroid men. Free Androgen Index was significantly (p < 0.005) decreased in hyperthyroid males. No other auto immune diseases were noticed. Our results indicate that the function of the H-P-G axis is not impaired in hyperthyroid patients, but gonadotropin levels are increased. Hyperthyroid men show relative primary gonadal insufficiency that may be due to exaggerated SHBG levels. The copulsatility of LH and FSH, and of LH and PRL was confirmed both in patients and controls.

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1 * Supported by DAAD grant (II, 314)

Priv.-Doz. Dr. Jochen Schopohl

Medizinische Klinik Innenstadt

Klinikum der Ludwig-Maximilians-Universität

Ziemssenstraße 1

D-80336 München

Phone: + 49-89-51 60-23 33

Fax: + 49-89-51 60-45 66

Email: Jochen.Schopohl@medinn.med.uni-muenchen.de