Why you should be running T4 with your GH

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Thyroid Hormone + Growth Hormone – If You Aren’t Using T4 with Your GH, You’re Not Doing It Right

By: Anthony Roberts

Quite some time ago, I wrote a book on Anabolics, and since then, I’ve received quite a bit of feedback on it. Some of the information contained in the book is based on the 50-60 profiles I completed for Steroid.com’s main page. As a result, I get feedback on certain portions of the book from people who have read them online.

When someone takes the time to send an e-mail to Steroid.com or AnabolicBooks LLC, they’re screened, and eventually some of them make their way to my e-mail account. AnabolicBooks LLC is publisher- a little known fact is that my book is actually wasn’t edited by me, nor do I own the rights to any of it. When they forward an e-mail to me, I typically consider it very carefully, and reply to the original sender. If amendments or additions are useful for anything I’ve previously written (readers frequently send me recently published studies), I typically reply and thank the person for their help.

This time, something odd happened. I was forwarded an e-mail from AnabolicBooks, and the reader seemed to know what he was talking about, but (I thought) mistaken about interactions between Growth Hormone and Thyroid medication. I took a look at the e-mail, and knew that I could quickly find a study that I had saved previously, to send to the reader, to verify that the claims in my work on GH were sound.

In this particular case- James Daemon, PhD- was the reader, and was correct in his assessment of the interaction between thyroid hormone and Growth Hormone. And, in direct contradiction, so was I. Thyroid medication decreases the anabolic effect of Growth Hormone. And it increases it.

Huh?

There’re some leaps here, because research in some of the necessary areas is sketchy (or not done yet), but if you read the entirety of this article, you’ll learn how to get a significantly more gains from Growth Hormone, for pennies a day, by the addition of a readily available (and cheap) addition to it. And yeah, it’s a drug you can get anywhere on the ‘net, very easily. And no, it’s not a steroid.

In fact, I’ll go so far as to say you’re throwing away a substantial portion of your gains from growth hormone if you are not using this drug with it.

Ok…I’ll explain things a bit further. First, a brief explanation of Thyroid Hormone as well as Growth Hormone may be necessary.

Your thyroid gland secretes two hormones that are going to be of primary importance in understanding Thyroid/GH interaction. The first is thyroxine (T4) and the second is triiodothyronine (T3). T3 is frequently considered the physiologically active hormone, and consequently the one on which most athletes and bodybuilders focus their energies on. T4, on the other hand, is converted in peripheral tissue into T3 by the enzymes in the deiodinase group, of which there are three types- the three iodothyronine deiodinase either catalyze the initiation (D1, D2) or termination (D3) of thyroid hormone effects. The majority of the body’s T3 (about 80%) comes from this conversion via the first two types of deiodinase, while conversion to an inactive state is accomplished by the third type.

It’s important to note that not all of the body’s T4 is converted to T3, however- some remains unconverted. The secretion of T4 is under the control of Thyroid Stimulating Hormone (TSH) which is produced by the pituitary gland. TSH secretion is in turn controlled through release of Thyrotropin Releasing Hormone which is produced in your hypothalamus. So, when T3 levels go up, TSH secretion is suppressed, due to the body’s self regulatory system known as the “negative feedback loop” . This is also the mechanism whereby exogenous thyroid hormone suppresses natural thyroid hormone production. However, it should be noted that thyroid stimulating hormone (like all other hormones) can not work in a vacuum. TSH also requires the presence of Insulin or Insulin-like Growth Factor to stimulate thyroid function (1) When thyroid hormone is present without either insulin or IGF-1, it has no physiological effect (ibid).

Most people think that T3 is just a physiologically active hormone that regulates bodyfat setpoint and has some minor anabolic effects, but in actuality, in some cases of delayed growth in children, T3 is actually too low, while GH levels are normal, and this has a growth limiting effect on several tissues (2) This could be due to T3’s ability to stimulate the proliferation of IGF-1 mRNA in many tissues (which would, of course, be anabolic), or it could be due to the synergistic effect T3 has on GH, specifically on regulation of the growth hormone gene. Although it is largely overlooked in the world of performance enhancement, regulation of the growth hormone response is predominantly determined by positive control of growth hormone gene transcription which is proportional to the concentration of thyroid hormone-receptor complexes, which are influenced by T3 levels. (3)

At this point, just to give you a better understanding of what’s going on, I think it’s prudent to also give a brief explanation of Growth Hormone (GH) as well.

Your body’s GH is regulated by many internal factors, such as hormones and enzymes. hormones. A change in the level of your body’s GH output begins in the hypothalamus with somatostatin (SS) and growth hormone-releasing hormone (GHRH). Somatostatin exerts its effect at the pituitary to decrease GH output, while GHRH acts at the pituitary to increase GH output. Together these hormones regulate the level of GH you have in your body. In many cases, GH deficiency presents with a low level of T3, and normal T4(4). This is of course because conversion of T4-T3 is partially dependant on GH (and to some degree GH stimulated IGF-1), and it’s ability to stimulate that conversion process of T4 into T3.

Interestingly, the hypothalamus isn’t the only place where SS is contained; the thyroid gland also contains Somatostatin-producing cells. This is of interest to us, because in the case of the thyroid, it’s been noted that certain hormones which were previously thought only to govern GH secretion can also influence thyroid hormone output as well. SS can directly act to inhibit TSH secretion or it may act on the hypothalamus to inhibit TRHsecretion. So when you add GH into your body from an outside source, you are triggering the body into releasing SS, because your body no longer needs to produce its own supply of GH…and unfortunately, the release of SS can also inhibit TSH, and therefore limit the amount of T4 your body produces.

But that’s not the only interaction we see between the thyroid and Growth Hormone.

As we learned in high-school Biology class, the body likes to maintain homeostasis, or “normal” operating conditions. This is the body’s version of the status quo, and it fights like hell to maintain the comfort of the status quo (much like moderators on most steroid discussion boards). What we see with thyroid/GH interplay is that physiological levels of circulating thyroid hormones are necessary to maintain normal pituitary GH secretion, due to their directly stimulatory actions. However, when serum concentrations of thyroid hormone increase above the normal range we see an increase in hypothalamic somatostatin action, which suppresses pituitary GH secretion and overrides any stimulatory effects that the thyroid hormone may have had on GH. The suppression of GH secretion by thyroid hormones is probably mediated at the hypothalamic level by a decrease in GHRH release(5).

In addition, as IGF-I production isincreased in the hypothalamus after T3 administration and T3 may participate in IGF-1 mediated negative feedback of GH by triggeringeither increased somatostatin tone and/or decreased GHRH production (6). IGF, interestingly, has the ability to mediate some of T3’s effects independent of GH, but not to the same degree GH can (7.) In fact, IGF-I production isincreased in the hypothalamus after T3, administration it may plausibly participate in negative feedback by triggeringeither increased somatostatin tone and/or decreased GHRH production.So we know that GH lowers T4 (more about this in a sec), but an increase in T3 upregulates GH receptors (8) as well as IGF-1 receptors (9,10).

As can be previously stated, and due to the ability of GH to convert inactive T4 into active T3, GH administration in healthy athletes shows us an entirely predicatble increase in mean free T3 (fT3), and a decrease in mean free T4 (fT4)levels.(11)

hGH converts inactive T4 into active T3

Interaction between GH, IGF-I, T3, and GC. GH stimulates hepatic IGF-I secretion and local production of growth plate IGF-I, and exerts direct actions in the growth plate. Circulating T3 is derived from the thyroid gland and by enzymatic deiodination of T4 in liver and kidne.. The regulatory 5′-DI and 11ßHSD type 2 enzymes may also be expressed in chondrocytes to control local supplies of intracellular T3 and GC. Receptors for each hormone (GHR, IGF-IR, TR, GR) are expressed in growth plate chondrocytes.

So, with the use of GH, what we see is an increased conversion of T4-T3, and possible inhibition of Thyroid Releasing Hormone by Somatostatin, and therefore even though T3 levels may rise, there is no increase in T4 (logically, we see a decrease). Now, as we’ve seen, GH is HIGHLY synergistic with T3 in the body, and as a mater of fact, if you’ve been paying any attention up until this point, you’ll note that the limiting factor on GH’s ability to exert many of it’s effects, is mediated by the amount of T3 in the body.

As noted before, T3 enhances many effects of GH by several mechanisms, including (but not limited to): increasing IGF-1 levels, IGF-1 mRNA levels, and finally by actually mediating the control of the growth hormone gene transcription process as seen below:

Comparison of the kinetics of L-T3-receptor binding abundance to changes in the rate of transcription of the GH gene.(3)

As you can see, T3 levels are directly correlative to GH gene transcription. The scientists who conducted the study which provided the graph above concluded that the amount of T3 present is a regulatory factor on how much GH gene transcription actually occurs. And gene transcription is what actually gives us the effects from GH. This last fact really seems to shed some light on why we need T3 levels to be supraphysiological if we’re going to be using supraphysiological levels of GH, right? Otherwise, the GH we’re using is going to be limited by the amount of T3 our body produces. However, since we’re taking GH, and it is converting more T4 into T3, T4 levels are lowered substantially, and this is the problem with GH. and may actually be THE limiting factor on GH…if we assume that at least some of GH’s effects are enhanced by thyroid hormone, and specifically T3, then what we are looking at is the GH that has been injected is being limited by a lack of T3. But that doesn’t make sense, because if we use T3 + GH, we get a decrease in the anabolic effect of GH.

This is where Mr. Daemon, who had contacted me via an e-mail to my publisher, about Thyroid + GH interaction, was able to shed some light on things. You see, I knew that it couldn’t just be the actual presence of enough T3 along with the GH that was limiting GH’s anabolic effect, because, simply adding T3 to a GH cycle will reduce the anabolic effect of the GH (12.).

Originally, he had said to me that T3 was synergistic with GH, wheras I said that T3 actually reduced the anabolic effects of GH- now I realize we were both correct. Logically this presents a bit of a problem, which I believe can be solved. This came from reading several studies provided to me by Dr.Daemon. the trend I was seeing was that even when Growth Hormone therapy was used, T3 levels needed to be elevated in order to treat several conditions caused by a lack of natural growth hormone. And even if the patient was on GH, T3 levels still needed to be elevated. And what I noticed was that those levels were elevated successfully by using supplemental T4 but not T3.

Here’s why I think this is:

Additional T3 is not all that’s needed here. What’s needed is the actual conversion process of T4-T3, and the deiodinase presence and activity that it involves. This is because Local 5′-deiodination of l-thyroxine (T4) to active the thyroid hormone 3,3′,5-tri-iodothyronine (T3) is catalyzed by the two 5′-deiodinase enzymes (D1 and D2). These enzymes not only “create” T3 out of T4, but actually regulates various T(3)-dependent functions in many tissues including the anterior pituitary and liver. So when there is an excess of T3 in the body, but normal levels of T4, the body’s thyroid axis sends a negative feedback signal., and produces less (D1 and D2) deiodinase, but more of the D3 type, which signals the cessation of the T4-T3 conversion process, and is inhibitory of many of the synergistic effects that T3 has! Remember, Type 3 iodothyronine deiodinase (D3) is the physiologic INACTIVATOR of thyroid hormones and their effects (13)and is well known to have independent interaction with growth factors (which is what GH and IGF-1 are).(14) This is because with adequate T4 and excess T3, (D1 and D2) deiodinase is no longer needed for conversion of T4 into T3, but levels of D3 deiodinase will be elevated. When there is less of the first two types of deidinase, it would seem that the T3 which has been converted to T4 can not exert it’s protein sparing (anabolic effects), as those first two types are responsible for mediation of many of the effects T3 has on the body. This seems to be one of the ways deiodinase contributes to anabolism in the presence of other hormones.

All of this would explain why anecdotally we see bodybuilders who use T3 lose a lot of muscle if they aren’t using anabolics along with it- they’re not utilizing the enzyme that would regulate some of T3’s ability to stimulate protein synthesis, while they are simultaneously signaling the body to produce an inhibitory enzyme (D3). And remember, for decades bodybuilders who were dieting for a contest have been convinced that you lose less muscle with T4 use, but that it’s less effective for losing fat when compared with T3? Well, as we’ve seen, without something (GH in this case) to aid in the conversion process, it would clearly be less effective! Since the deiodinase enzyme is also located in the liver, and we see decreased hepatic nitrogen clearance with GH + T3, it would seem that the D3 enzyme is exerting it’s inhibitory effects, but in the absence of the effects of the first two deiodinase enzymes, it remains unchecked and therefore not only limits the GH’s nitrogen retention capability.

In other words, if we have enough to GH in our body aid in supraphysiological conversion of T4 into T3, but we already have the too much (exogenous) T3, the GH is not going to be converting any excess T4 into T3 after a certain point- which would be a limiting factor in GH’s anabolic effects, when coupled with the act that we’ve allowed the D3 enzyme to inhibit the T3/GH synergy that is necessary.

As further evidence, when we look at certain types of cellular growth (the cartilage cell in this case) we see that GH induced rises in IGF-I stimulates proliferation, whereas T3 is responsible for hypertrophic differentiation. So it would seem that in some tissues, IGF-1 stimulates the synthesis of new cells, while T3 makes them larger. In this particular case, The fact that T4 and (D1) deiodinase is am active component in this system is noted by the authors. They clearly state (paraphrasing) that: “T4 is is converted to T3 by deiodinase (5′-DI type 1) in peripheral tissues…[furthermore]GH stimulates conversion of T4 to T3 , suggesting that some effects of GH may involve this pathway.” The thing I want you to notice is that the authors of this paper state that the that the conversion PATHWAY is probably involved, and not the simple presence of T3. (15 )

Also, that same study notes that T3 has the ability to stimulates IGF-I and expression in tissues that whereas GH has no such effect (ibid).

So what are we doing when we add T3 to GH? We’re effectively shutting down the conversion pathway that is responsible for some of GH’s effects! And what would we be doing if we added in T4 instead of T3? You got it- we’d be enhancing the pathway by allowing the GH we’re using to have more T4 to convert to T3, thus giving us more of an effect from the GH we’re taking. Adding T4 into our GH cycles will actually allow more of the GH to be used effectively!

Remember, the thing that catalyzes the conversion process is the deiodinase enzyme. This is also why using low amounts of T3 would seem (again, anecdotally in bodybuilders) to be able to slightly increase protein synthesis and have an anabolic effect – they aren’t using enough to tell the body to stop or slow down production of the deiodinase enzyme, and hence .Although this analogy isn’t perfect, think of GH as a supercharger you have attached to your car…if you don’t provide enough fuel for it to burn at it’s increased output level, you aren’t going to derive the full effects. Thyroid status also may influence IGF-I expressionin tissues other than the liver.So what we have here is a problem. When we take GH, it lowers T3 levels…but we need T3 to keep our GH receptor levels optimally upregulated. In addition, it’s suspected that many of GH’s anabolic effects are engendered as a result of production of IGF-1, so keeping our IGF receptors upregulated by maintaining adequate levels of T3 seems prudent. But as we’ve just seen, supplementing T3 with our GH will abolish Growth Hormone’s functional hepatic nitrogen clearance, possibly through the effect of reducing the bioavailability of insulin-like growth factor-I (12.)

So we want elevated T3 levels when we take GH, or we won’t be getting ANYWHERE NEAR the full anabolic effect of our injectable GH without enough T3. And now we know that not only do we need the additional T3, but we actually want the CONVERSION process of T4 into T3 to take place, because it’s the presence of those mediator enzymes that will allow the T3 to be synergistic with GH, instead of being inhibitory as is seen when T3 is simply added to a GH cycle. And remember, we don’t only want T3 levels high, but we want types 1 and 2 deiodinase to get us there- and when we take supplemental T3, that just doesn’t happen…all that happens is the type 3 deiodinase enzyme shows up and negates the beneficial effects of the T3 when we combine it with GH.

And that’s where myself and Dr. Daemon ended up, after a week of e-mails, researching studies, and gathering clues.

If you’ve been using GH without T4, you’ve been wasting half your money – and if you’ve been using it with T3, you’ve been wasting your time. Start using T4 with your GH, and you’ll finally be getting the full results from your investment.

T4 - thyroxine - thyroid hormones
T4 – thyroxine – thyroid hormones
References:

GrowthFactors. 1990;2(2-3):99-109.Interaction of TSH, insulin and insulin-like growth factors in regulating thyroid growth and function. Eggo MC, Bachrach LK, Burrow GN.

F, Rumpler M, Klaushofer K 1994 Thyroid hormones increase insulin-like growth factor mRNA levels in the clonal osteoblastic cell line MC3T3- E1. FEBS Lett 345: 67–70

Relationship of the rate of transcription to the level of nuclear thyroid hormone-receptor complexes.J Biol Chem. 1984 May 25;259(10):6284-91. Yaffe BM, Samuels HH.

Thyroid morphology and function in adults with untreated isolated growth hormone deficiency. J Clin Endocrinol Metab. 2006 Mar;91(3):860-4. Epub 2006 Jan 4.

Eur J Endocrinol.1995 Dec;133(6):646-53.Influence of thyroid hormones on the regulation of growth hormone secretion. Giustina A, Wehrenberg WB.

Binoux M, Faivre-Bauman A, Lassarre C, Tixier-Vidal A 1985 Triiodothyronine stimulates the production of insulin-like growth factor I (IGF-I) by fetal hypothalamus cells cultured in serum free medium. Dev Brain Res 21:319–323

Eur J Endocrinol. 1996 May;134(5):563-7.Insulin-like growth factor I alters peripheral thyroid hormone metabolism in humans: comparison with growth hormone.Hussain MA, Schmitz O, Jorgensen JO, Christiansen JS, Weeke J, Schmid C, Froesch ER

Harakawa S, Yamashita S, Tobinaga T, Matsuo K, Hirayu H, Izumi M, Nagataki S, Melmed S. In vivo regulation of hepatic insulin-like growth factor-1 messenger ribonucleic acids with thyroid hormone. Endocrinol Jpn 37(2):205-11, 1990

Hochberg Z, Bick T, Harel Z Alterations of human growth hormone binding by rat liver membranes during hypo- and hyperthyroidism. Endocrinology 126(1):325-9, 1990

Matsuo K, Yamashita S, Niwa M, Kurihara M, Harakawa S, Izumi M, Nagataki S, Melmed S Thyroid hormone regulates rat pituitary insulin-like growth factor-I receptors. Endocrinology 126(1):550-4, 1990

The Journal of Clinical Endocrinology & Metabolism Vol. 88, No. 11 5221-5226, 2003. High Dose Growth Hormone Exerts an Anabolic Effect at Rest and during Exercise in Endurance-Trained Athletes M. L. Healy, J. Gibney, D. L. Russell-Jones, C. Pentecost, P. Croos, P. H. Sönksen and A. M. Umpleby

J Hepatol. 1996 Mar;24(3):313-9. Effects of long-term growth hormone (GH) and triiodothyronine (T3) administration on functional hepatic nitrogen clearance in normal man.Wolthers T, Grofte T, Moller N, Vilstrup H, Jorgensen JO

Huang, SA. Physiology and pathophysiology of type 3 deiodinase in humans. Thyroid. 2005 Aug;15(8):875-81. Review.

Hernandez. A. Structure and function of the type 3 deiodinase gene.Thyroid. 2005 Aug;15(8):865-74. Review.

F, Rumpler M, Klaushofer K 1994 Thyroid hormones increase insulin-like growth factor mRNA levels in the clonal osteoblastic cell line MC3T3- E1. FEBS Lett 345: 67–70

[emoji767] 2005 Par Deus Inc. All Rights Reserved. Reprinted with permission.
 
Damn that was a good read. I was gonna use t3 instead of t4 for an upcoming gh blast but guess ill be investing in some t4 now ! Thanks for posting this up bro !
 
There info in this article is questionable. It has been a "controversial" article on the forums for quite a while.
Oh definitely this is all anecdotal really when it comes down to it, I believe he goes over that in the article as well. I think its a pretty good well thought out thesis though with very good supporting evidence. @ChestRockwell is a big proponent of running thyroid hormones with GH from what I've read in his post, im curious to see what his opinion is on this.
 
Oh definitely this is all anecdotal really when it comes down to it, I believe he goes over that in the article as well. I think its a pretty good well thought out thesis though with very good supporting evidence. @ChestRockwell is a big proponent of running thyroid hormones with GH from what I've read in his post, im curious to see what his opinion is on this.

Mands likes T4 with his GH.

I never really could tell where Roberts was jumping to the conclusion that the conversion is what is so crucial here... That is the most important part of his hypothesis here and it's the only one I really don't see him cite any evidence for.
 
Mands likes T4 with his GH.

I never really could tell where Roberts was jumping to the conclusion that the conversion is what is so crucial here... That is the most important part of his hypothesis here and it's the only one I really don't see him cite any evidence for.
Exactly thats where the whole theory really begins, They provide evidence for everything but that. But i think its a pretty good hypothesis imo for the reasons they stated. There is no real study to reference though so i see where you're coming from.
 
If in doubt, check T4/T3 while on GH.

Excess T3 will cause muscle loss.

In children, there appears to be findings for thyroid dysfunction that resolves. In adults, see below.

Ciresi A, Guarnotta V, Amato MC, Giordano C. Correlation between severity of growth hormone deficiency and thyroid metabolism and effects of long-term growth hormone treatment on thyroid function in children with idiopathic growth hormone deficiency. Horm Res Paediatr 2014;81(6):379-85. http://www.karger.com/Article/Abstract/356907

BACKGROUND/AIM: The significance of changes in thyroid function in children during growth hormone (GH) treatment remains uncertain. We aimed to evaluate the impact of GH replacement on thyroid status in children with idiopathic GH deficiency (GHD).

METHODS: Data of 105 GHD children (82 M, 23 F; aged 11.13 years) during a 36-month follow-up were analyzed. At diagnosis the areas under the curve of GH (AUCGH) were calculated during a GH-releasing hormone + arginine (GHRH-Arg) and insulin tolerance test.

RESULTS: A significant DeltafT3 (p < 0.001) was documented at 12 months, without any further change at 24 and 36 months and without fT4 and TSH modifications. Grouping patients according to DeltafT3 at 12 months into those with lower (n = 80, 76%) or greater values than the 75th percentile (n = 25, 24%), the latter showed lower AUCGH and GH peak during a GHRH-Arg (p = 0.018 and 0.014, respectively) and insulin tolerance test (p = 0.023 and 0.020, respectively) at diagnosis. In addition, children with lower GH at diagnosis showed a greater DeltafT3 at 12 months (p = 0.030).

CONCLUSIONS: In GHD children, GH treatment is associated with a significant increase in fT3 in the first 12 months, more pronounced in patients with more severe GHD, highlighting the strong correlation between severity of GHD and thyroid metabolism.


Hubina E, Mersebach H, Rasmussen ÅK, et al. Effect of Growth Hormone Replacement Therapy on Pituitary Hormone Secretion and Hormone Replacement Therapies in GHD Adults. Hormone Research in Paediatrics 2004;61(5):211-7. http://www.karger.com/Article/Abstract/76538

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.


The relationships between GH secretion and thyroid function, as well as the effects of rhGH administration on thyroid hormone levels have been the subject of numerous studies.

The data of Cacciari et al. [1], presented 30 years ago, indicated that the risk of inducing an alteration in thyroid function in hypopituitary patients during rhGH therapy was only slight and that the abnormal values of thyroxine (T4) and triiodothyronine (T3) returned to normal limits during follow-up.

Next, Gács and Bános [2] reported that rhGH therapy in children with idiopathic GHD reduced T4 secretion and affected the peripheral metabolism of thyroid hormones, resulting in an increase of T3.

In 1994, Jørgensen et al. [3] reported that, in GH-deficient adults, rhGH administration stimulated peripheral T4 to T3 conversion in a dose-dependent manner and influenced circadian rhythm of thyrotropin (TSH) secretion. Moreover, in some of those patients before rhGH administration, serum T3 levels were subnormal despite T4 substitution and normalised during the therapy.

As it was shown that rhGH administration might induce a fall in serum T4, it seemed probable that GHD could mask secondary hypothyroidism in some patients with hypopituitarism.

Recently, Agha et al. [4] proved that rhGH administration really led to „unmasking” hypotyroidism in hypopituitary adults. Similar were the observations of Losa et al. [5], who reported that, in adults with GHD, administration of rhGH therapy was associated with a significant decrease of free T4 (FT4) in first 6 months of treatment.


[OA] Smyczynska J, Hilczer M, Stawerska R, Lewinski A. Thyroid function in children with growth hormone (GH) deficiency during the initial phase of GH replacement therapy - clinical implications. Thyroid Res 2010;3(1):2. Thyroid function in children with growth hormone (GH) deficiency during the initial phase of GH replacement therapy - clinical implications

BACKGROUND: Normal thyroid hormone secretion or appropriate L-thyroxine (L-T4) substitution is necessary for the optimal effect of the growth hormone (GH) administration on growth rate. The decrease of free thyroxine (FT4) levels at recombinant human GH (rhGH) therapy onset has been reported in several studies. The aim of the present study was to evaluate the effect of rhGH administration on thyrotropin (TSH) and FT4 serum concentrations in children with GH deficiency (GHD) during the 1st year of therapy, as well as to assess potential indications to thyroid hormone supplementation in them.

PATIENTS AND METHODS: The analysis involved data of 75 children (59 boys, 16 girls) with disorders of GH secretion (GHD, neurosecretory dysfunction - NSD) and partial GH inactivity (inactGH), who were treated with rhGH for - at least - one year. In all the children, body height and height velocity (HV) were assessed before and after 1 year of therapy, while TSH, FT4, IGF-I and IGFBP-3 before treatment and after 3-6 months and 1 year of treatment. In the patients, who revealed hypothyroidism (HypoT), an appropriate L-T4 substitution was introduced immediately. The incidence of HypoT, occurring during the initial phase of rhGH therapy, was assessed, as well as its influence on the therapy effectiveness.

RESULTS: Before rhGH substitution, there were no significant differences in either auxological indices or TSH and FT4 secretion, or IGF-I concentration and its bioavailability among the groups of patients. During the initial 3-6 months of rhGH administration, a significant decrease of FT4 serum concentration, together with a significant increase of IGF-I SDS and IGF-I/IGFBP-3 molar ratio was observed in all the studied groups. In 17 children, HypoT was diagnosed and L-T4 substitution was administered. Despite similar IGF-I secretion increase, the improvement of HV presented significantly lower in children with HypoT than in those who remained euthyroid all the time.

CONCLUSIONS: The incidence of HypoT during the initial phase of GH treatment in children with GHD and the negative effect of even transient thyroid hormone deficiency on the growth rate should be taken into account.
 
Not needed you can raise your t3 with carbs.
But again depending on dosage.
If it's fat loss 2-3 iu is all your need needed up to year mark.
With that dose you don't have to worry about thyroid and again can't be suppressed more than 6 weeks
 
If in doubt, check T4/T3 while on GH.

Excess T3 will cause muscle loss.

In children, there appears to be findings for thyroid dysfunction that resolves. In adults, see below.

Ciresi A, Guarnotta V, Amato MC, Giordano C. Correlation between severity of growth hormone deficiency and thyroid metabolism and effects of long-term growth hormone treatment on thyroid function in children with idiopathic growth hormone deficiency. Horm Res Paediatr 2014;81(6):379-85. http://www.karger.com/Article/Abstract/356907

BACKGROUND/AIM: The significance of changes in thyroid function in children during growth hormone (GH) treatment remains uncertain. We aimed to evaluate the impact of GH replacement on thyroid status in children with idiopathic GH deficiency (GHD).

METHODS: Data of 105 GHD children (82 M, 23 F; aged 11.13 years) during a 36-month follow-up were analyzed. At diagnosis the areas under the curve of GH (AUCGH) were calculated during a GH-releasing hormone + arginine (GHRH-Arg) and insulin tolerance test.

RESULTS: A significant DeltafT3 (p < 0.001) was documented at 12 months, without any further change at 24 and 36 months and without fT4 and TSH modifications. Grouping patients according to DeltafT3 at 12 months into those with lower (n = 80, 76%) or greater values than the 75th percentile (n = 25, 24%), the latter showed lower AUCGH and GH peak during a GHRH-Arg (p = 0.018 and 0.014, respectively) and insulin tolerance test (p = 0.023 and 0.020, respectively) at diagnosis. In addition, children with lower GH at diagnosis showed a greater DeltafT3 at 12 months (p = 0.030).

CONCLUSIONS: In GHD children, GH treatment is associated with a significant increase in fT3 in the first 12 months, more pronounced in patients with more severe GHD, highlighting the strong correlation between severity of GHD and thyroid metabolism.


Hubina E, Mersebach H, Rasmussen ÅK, et al. Effect of Growth Hormone Replacement Therapy on Pituitary Hormone Secretion and Hormone Replacement Therapies in GHD Adults. Hormone Research in Paediatrics 2004;61(5):211-7. http://www.karger.com/Article/Abstract/76538

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.


The relationships between GH secretion and thyroid function, as well as the effects of rhGH administration on thyroid hormone levels have been the subject of numerous studies.

The data of Cacciari et al. [1], presented 30 years ago, indicated that the risk of inducing an alteration in thyroid function in hypopituitary patients during rhGH therapy was only slight and that the abnormal values of thyroxine (T4) and triiodothyronine (T3) returned to normal limits during follow-up.

Next, Gács and Bános [2] reported that rhGH therapy in children with idiopathic GHD reduced T4 secretion and affected the peripheral metabolism of thyroid hormones, resulting in an increase of T3.

In 1994, Jørgensen et al. [3] reported that, in GH-deficient adults, rhGH administration stimulated peripheral T4 to T3 conversion in a dose-dependent manner and influenced circadian rhythm of thyrotropin (TSH) secretion. Moreover, in some of those patients before rhGH administration, serum T3 levels were subnormal despite T4 substitution and normalised during the therapy.

As it was shown that rhGH administration might induce a fall in serum T4, it seemed probable that GHD could mask secondary hypothyroidism in some patients with hypopituitarism.

Recently, Agha et al. [4] proved that rhGH administration really led to „unmasking” hypotyroidism in hypopituitary adults. Similar were the observations of Losa et al. [5], who reported that, in adults with GHD, administration of rhGH therapy was associated with a significant decrease of free T4 (FT4) in first 6 months of treatment.


[OA] Smyczynska J, Hilczer M, Stawerska R, Lewinski A. Thyroid function in children with growth hormone (GH) deficiency during the initial phase of GH replacement therapy - clinical implications. Thyroid Res 2010;3(1):2. Thyroid function in children with growth hormone (GH) deficiency during the initial phase of GH replacement therapy - clinical implications

BACKGROUND: Normal thyroid hormone secretion or appropriate L-thyroxine (L-T4) substitution is necessary for the optimal effect of the growth hormone (GH) administration on growth rate. The decrease of free thyroxine (FT4) levels at recombinant human GH (rhGH) therapy onset has been reported in several studies. The aim of the present study was to evaluate the effect of rhGH administration on thyrotropin (TSH) and FT4 serum concentrations in children with GH deficiency (GHD) during the 1st year of therapy, as well as to assess potential indications to thyroid hormone supplementation in them.

PATIENTS AND METHODS: The analysis involved data of 75 children (59 boys, 16 girls) with disorders of GH secretion (GHD, neurosecretory dysfunction - NSD) and partial GH inactivity (inactGH), who were treated with rhGH for - at least - one year. In all the children, body height and height velocity (HV) were assessed before and after 1 year of therapy, while TSH, FT4, IGF-I and IGFBP-3 before treatment and after 3-6 months and 1 year of treatment. In the patients, who revealed hypothyroidism (HypoT), an appropriate L-T4 substitution was introduced immediately. The incidence of HypoT, occurring during the initial phase of rhGH therapy, was assessed, as well as its influence on the therapy effectiveness.

RESULTS: Before rhGH substitution, there were no significant differences in either auxological indices or TSH and FT4 secretion, or IGF-I concentration and its bioavailability among the groups of patients. During the initial 3-6 months of rhGH administration, a significant decrease of FT4 serum concentration, together with a significant increase of IGF-I SDS and IGF-I/IGFBP-3 molar ratio was observed in all the studied groups. In 17 children, HypoT was diagnosed and L-T4 substitution was administered. Despite similar IGF-I secretion increase, the improvement of HV presented significantly lower in children with HypoT than in those who remained euthyroid all the time.

CONCLUSIONS: The incidence of HypoT during the initial phase of GH treatment in children with GHD and the negative effect of even transient thyroid hormone deficiency on the growth rate should be taken into account.
Dr Scally, just had bloods down while on GH. Taking T4 at 200mcg per day, TSH came back low obviously, T4 at 6.7 (lowish end of the normal range), and T3 uptake at 40 (1 point out of normal range).

The range for T3 uptake is relatively small, so I guess 1 point over could be considered something to scrutinize. Would it be smart for me to cut T4 dosage in half to bring it into range... by that I mean is there much of a difference in terms of what my body is doing between say a level of 40% and 35%
 
Oh definitely this is all anecdotal really when it comes down to it, I believe he goes over that in the article as well. I think its a pretty good well thought out thesis though with very good supporting evidence. @ChestRockwell is a big proponent of running thyroid hormones with GH from what I've read in his post, im curious to see what his opinion is on this.

There is a very complicated interplay between the GH/IGF axis and the thyroidal axis. Multiple trials in both GHD and healthy subjects have shown that GH enhances the peripheral deiodination of T4-T3. However, I'm not ready to get on the side of the argument which mandates there are going to be any advantages with supplementation of supraphysiological T4, as there is some data to suggest this effect on peripheral deiodination is acute in nature.

If anything, we can say it makes an interesting conversational topic.
 
Dr Scally, just had bloods down while on GH. Taking T4 at 200mcg per day, TSH came back low obviously, T4 at 6.7 (lowish end of the normal range), and T3 uptake at 40 (1 point out of normal range).

The range for T3 uptake is relatively small, so I guess 1 point over could be considered something to scrutinize. Would it be smart for me to cut T4 dosage in half to bring it into range... by that I mean is there much of a difference in terms of what my body is doing between say a level of 40% and 35%
@ChestRockwell your opinion here would be appreciated as well
 
There is a very complicated interplay between the GH/IGF axis and the thyroidal axis. Multiple trials in both GHD and healthy subjects have shown that GH enhances the peripheral deiodination of T4-T3. However, I'm not ready to get on the side of the argument which mandates there are going to be any advantages with supplementation of supraphysiological T4, as there is some data to suggest this effect on peripheral deiodination is acute in nature.

If anything, we can say it makes an interesting conversational topic.
I've never ran gh with thyroid hormone but i am considering it this go around.
 
If in doubt, check T4/T3 while on GH.

Excess T3 will cause muscle loss.

In children, there appears to be findings for thyroid dysfunction that resolves. In adults, see below.

Ciresi A, Guarnotta V, Amato MC, Giordano C. Correlation between severity of growth hormone deficiency and thyroid metabolism and effects of long-term growth hormone treatment on thyroid function in children with idiopathic growth hormone deficiency. Horm Res Paediatr 2014;81(6):379-85. http://www.karger.com/Article/Abstract/356907

BACKGROUND/AIM: The significance of changes in thyroid function in children during growth hormone (GH) treatment remains uncertain. We aimed to evaluate the impact of GH replacement on thyroid status in children with idiopathic GH deficiency (GHD).

METHODS: Data of 105 GHD children (82 M, 23 F; aged 11.13 years) during a 36-month follow-up were analyzed. At diagnosis the areas under the curve of GH (AUCGH) were calculated during a GH-releasing hormone + arginine (GHRH-Arg) and insulin tolerance test.

RESULTS: A significant DeltafT3 (p < 0.001) was documented at 12 months, without any further change at 24 and 36 months and without fT4 and TSH modifications. Grouping patients according to DeltafT3 at 12 months into those with lower (n = 80, 76%) or greater values than the 75th percentile (n = 25, 24%), the latter showed lower AUCGH and GH peak during a GHRH-Arg (p = 0.018 and 0.014, respectively) and insulin tolerance test (p = 0.023 and 0.020, respectively) at diagnosis. In addition, children with lower GH at diagnosis showed a greater DeltafT3 at 12 months (p = 0.030).

CONCLUSIONS: In GHD children, GH treatment is associated with a significant increase in fT3 in the first 12 months, more pronounced in patients with more severe GHD, highlighting the strong correlation between severity of GHD and thyroid metabolism.


Hubina E, Mersebach H, Rasmussen ÅK, et al. Effect of Growth Hormone Replacement Therapy on Pituitary Hormone Secretion and Hormone Replacement Therapies in GHD Adults. Hormone Research in Paediatrics 2004;61(5):211-7. http://www.karger.com/Article/Abstract/76538

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.


The relationships between GH secretion and thyroid function, as well as the effects of rhGH administration on thyroid hormone levels have been the subject of numerous studies.

The data of Cacciari et al. [1], presented 30 years ago, indicated that the risk of inducing an alteration in thyroid function in hypopituitary patients during rhGH therapy was only slight and that the abnormal values of thyroxine (T4) and triiodothyronine (T3) returned to normal limits during follow-up.

Next, Gács and Bános [2] reported that rhGH therapy in children with idiopathic GHD reduced T4 secretion and affected the peripheral metabolism of thyroid hormones, resulting in an increase of T3.

In 1994, Jørgensen et al. [3] reported that, in GH-deficient adults, rhGH administration stimulated peripheral T4 to T3 conversion in a dose-dependent manner and influenced circadian rhythm of thyrotropin (TSH) secretion. Moreover, in some of those patients before rhGH administration, serum T3 levels were subnormal despite T4 substitution and normalised during the therapy.

As it was shown that rhGH administration might induce a fall in serum T4, it seemed probable that GHD could mask secondary hypothyroidism in some patients with hypopituitarism.

Recently, Agha et al. [4] proved that rhGH administration really led to „unmasking” hypotyroidism in hypopituitary adults. Similar were the observations of Losa et al. [5], who reported that, in adults with GHD, administration of rhGH therapy was associated with a significant decrease of free T4 (FT4) in first 6 months of treatment.


[OA] Smyczynska J, Hilczer M, Stawerska R, Lewinski A. Thyroid function in children with growth hormone (GH) deficiency during the initial phase of GH replacement therapy - clinical implications. Thyroid Res 2010;3(1):2. Thyroid function in children with growth hormone (GH) deficiency during the initial phase of GH replacement therapy - clinical implications

BACKGROUND: Normal thyroid hormone secretion or appropriate L-thyroxine (L-T4) substitution is necessary for the optimal effect of the growth hormone (GH) administration on growth rate. The decrease of free thyroxine (FT4) levels at recombinant human GH (rhGH) therapy onset has been reported in several studies. The aim of the present study was to evaluate the effect of rhGH administration on thyrotropin (TSH) and FT4 serum concentrations in children with GH deficiency (GHD) during the 1st year of therapy, as well as to assess potential indications to thyroid hormone supplementation in them.

PATIENTS AND METHODS: The analysis involved data of 75 children (59 boys, 16 girls) with disorders of GH secretion (GHD, neurosecretory dysfunction - NSD) and partial GH inactivity (inactGH), who were treated with rhGH for - at least - one year. In all the children, body height and height velocity (HV) were assessed before and after 1 year of therapy, while TSH, FT4, IGF-I and IGFBP-3 before treatment and after 3-6 months and 1 year of treatment. In the patients, who revealed hypothyroidism (HypoT), an appropriate L-T4 substitution was introduced immediately. The incidence of HypoT, occurring during the initial phase of rhGH therapy, was assessed, as well as its influence on the therapy effectiveness.

RESULTS: Before rhGH substitution, there were no significant differences in either auxological indices or TSH and FT4 secretion, or IGF-I concentration and its bioavailability among the groups of patients. During the initial 3-6 months of rhGH administration, a significant decrease of FT4 serum concentration, together with a significant increase of IGF-I SDS and IGF-I/IGFBP-3 molar ratio was observed in all the studied groups. In 17 children, HypoT was diagnosed and L-T4 substitution was administered. Despite similar IGF-I secretion increase, the improvement of HV presented significantly lower in children with HypoT than in those who remained euthyroid all the time.

CONCLUSIONS: The incidence of HypoT during the initial phase of GH treatment in children with GHD and the negative effect of even transient thyroid hormone deficiency on the growth rate should be taken into account.
So just to clarify, you're saying its very dependant on the user and can vary from person to person correct? Or am i misinterpreting the data and your post??
 
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Yea, just throw another drug into the mix, wtf who cares. Maybe it works maybe it doesn't , might as well make sure and just blast everything and anything lol. I am sure at some point on some level this protocol is useful and necessary, but I feel that 99% of anyone running hgh wouldn't see any benefit.
 
Yea, just throw another drug into the mix, wtf who cares. Maybe it works maybe it doesn't , might as well make sure and just blast everything and anything lol. I am sure at some point on some level this protocol is useful and necessary, but I feel that 99% of anyone running hgh wouldn't see any benefit.
You are joking, right? Do you just spout random shit stone?

Studies, bloodwork and anecdotal evidence show otherwise.
 
You are joking, right? Do you just spout random shit stone?

Studies, bloodwork and anecdotal evidence show otherwise.
Just making a point, do you just run anything? What blood work? yours? Mine? whos? a bodybuilder? or some patient? Do you just believe any nonsense you read on the internet? Or do you take your health and training seriously? What was random about my opinion? Take it or leave it.
 
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