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Does Testosterone Influence Growth Hormone Secretion In Puberty?

Posted on Mon, 28 Jul 2014

Question: Dear Endocrinologist,

I had some steroids when i was teenager to boost my GH levels and thus boost height.

My question: does the presence of testosterone always positevely impact on GH even in male babies, children?

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
Hello

Detailed Answer:
Dear XXXXXX,

Good day.
Testosterone positively influence GH secretion in puberty. Even in the absence of testosterone surge in puberty, some GH is still secreted and some growth of skeleton and body occurs. However, for optimum GH secretion and action, body need androgen surge during puberty. This effect of androgens complimenting GH action is maxiumum in puberty and very minimal or absent in prepubertal life and in post pubertal life.

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (13 minutes later)

Dear Dr XXXXXXX thanks for your valued answer.

Its been suggested that presence of androgens leads to increased growth hormone levels. Possibly by action on pituitary somatrophs.

Does this phenomenon exist in male babies during their 'mini puberty' ?

Best Regards

Answered by Dr. Binu Parameswaran Pillai (4 minutes later)

Brief Answer:
Hi

Detailed Answer:
Hi,
In minipuberty ( whch lasts from 6 months to 1 year after birth) there is minimal GH secretion. The growth of skeleteon is minimal in this period. The purpose of minipuberty is development of genital organs. Hence there is no much influence of androgens on GH axis during XXXXXXX puberty.
regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (10 hours later)

Thanks Dr XXXXXXX

This is bad news for me because it means the 'first ever' androgen stimulated GH increase was due to the steroids i took....and not endogonous androgens.

The steroids was daily 2.5mg oxandrolone for three months. At the time, i was in very early puberty and two years prior had adrenarche. My growth was 5cm per year.

Can we say my endogonous androgens also helped increase GH prior to oxandrolone treatment?

Thanks and Best Regards
XXXXXXX

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
Hi

Detailed Answer:
Yes ofcourse. At the time of adrenarche, the adrenal androgens initiate the growth of sex organs and pubic/axillary hair growth to a certain extent and it will start priming the pituitary somatotrops as well. At that time, there will be an acceleration of height. Girls will have adrenarche 1-2 years before boys and that is when you notice the girls in your class suddenly grow taller compared to boys.

However, only after the real testicular androgen production start, the maximum height acceleration occurs.

In your case, the adrenarche itself would have kick started the puberty process and pituitary GH cells priming as well. The oxandralone in small dose would have just initiated the puberty process by helping the hypothalamic GnRH pulse generator to start firing. Once started, it will continue with out the help of oxandralone.

What is your height and weight Rony? What is the height of your parents? Are you a caucasian ? These details will help me to calculate your expected genetic height potential.

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (2 days later)

Dear Dr XXXXXXX thank you once again.

what i dont understand is how can oxandrolone cause both hypothalamic suppression (negative feedback) AND GnRH pulse firing at the same time??

Best Regards

Answered by Dr. Binu Parameswaran Pillai (2 hours later)

Brief Answer:
Small dose for short periods

Detailed Answer:
Hi,

Oxandrolone is a weak synthetic steroid ( androgen) and we use small doses for puberty initiation and for brief period only. Excess unphysiologic use of longer acting androgens/steroids for long period cause hypothalamic-pituitary-gonadal axis supression.

Small dose used for puberty initiation has a facilitatory effect where as large dose of steroids have inhibitory effect.

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (20 hours later)

Thank you Dr XXXXXXX for your valued answers.

One last question.

After the 'mini puberty' the HPG axis is inhibited till time approaching puberty. I remember reading inhibition just means operating at a low level. Is this true, or does inhibition mean complete shutdown of any GnRH pulses completely?

Thanks and wishing you all the best
XXXXXX

Answered by Dr. Binu Parameswaran Pillai (3 hours later)

Brief Answer:
Hi

Detailed Answer:
Hi XXXXXX,
Welcome back. Yes, you are right. After minipuberty, the GnRH pulse generator kind of go in to a hibernation state until puberty. However, low intensity pulsus will be generated at lesser frequency. This kind of impulses are not strong enough to produce LH or FSH generation in pituitary. In Precocious puberty, GnRH pulse generator start firing much before puberty. This is pathological and has to be arrested till the normal puberty age.

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (47 hours later)

Dear Dr XXXXXXX

I've just read in early puberty gonadotrophins are nocturnally released, and as puberty progresses, released during daytime also.

Sine steroid therapy progresses puberty, does this mean it was responsible for causing/evolving the first daytime release?

Is it logic to see it like this?

Regards
XXXXXXX

Answered by Dr. Binu Parameswaran Pillai (2 hours later)

Brief Answer:
hi

Detailed Answer:
You are right in that, earliest hypothalamic GNRH firing happens at night

. Even late,r the GNRH pulsations and LH/FSH secretion occur around every 90 minuute or so. This process is more robust in night.

When we induce the puberty, there is an initial stimulation which need not happen only at night. But once started, the process continue similar to the natural process.

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (2 hours later)

Thanks Dr XXXXXXX

Please could you advise....during early puberty ie 4ml testis, is there gonadotrophin secretion in any amount during daytime? Thanks

Answered by Dr. Binu Parameswaran Pillai (5 minutes later)

Brief Answer:
Hi

Detailed Answer:
Yes, there is. But in lower intensity compared to a stronger gonadotropin secretion at night. Similarly, growth hormone secretion also is more robust whilst the child sleep at night. That's why there is a saying that " children grow during sleep" and hence the importance of getting sufficient sleep during child hood.

Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (23 minutes later)

Thanks.

You mention above that drug stimulates gonadotropin, and need not be at night. And once started the process continues just like natural process - does this mean the drug started daytime secretion and remain that way ??

In XXXXXXX puberty is daytime as robust as nighttime. Im interested to know pattern of gonadotropin secretion before being born and after birth during XXXXXXX puberty. Many thanks

Answered by Dr. Binu Parameswaran Pillai (5 hours later)

Brief Answer:
Hi

Detailed Answer:
What i meant was that, the drug ( either testosterone or oxandrolone) stimulate hypothalamic GnRH and prime it.Then the firing start as if in the normal pubertal process. ( maximum at night).

In fetus, pituitary gland will start secretion of FSH and LH by 12 weeks of pregnancy and increase until 25th week of pregnancy. Then it decreases . Soon after birth, with in 3 hrs, LH and testosterone peaks and high levels persists until around 12 hours. Then it falls untile the XXXXXXX pubery kicks in few weeks later. In XXXXXXX puberty, i am not very sure if the secretion peaks at night ( but i would think so)

XXXXXX, i will be away until tomorrow evening and will answer if any more questions by tomorrow late evening here

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (33 hours later)

Thanks Dr XXXXXXX for all you valued advice.

In male uterine life and after being born, growth is constantly occuring. Are testosterone, growth hormone and thyroid all present after birth to help male baby grow?

Or do these hormones begin few years after being born?

Best regards
XXXXXXX

Answered by Dr. Binu Parameswaran Pillai (10 minutes later)

Brief Answer:
Hi

Detailed Answer:
Hello,
Testosterone levels peak soon after birth and then returns to baseline. It will peak again in XXXXXXX puberty and after that, it is minimal until puberty.
Growth hormone is present even during intrauterine life and children with growth hormone deficiency often is born with micro penis and prolonged neonatal jaundice. It is present through out life. But the levels peak during puberty which is augmented by androgens.

Thyroid hormone production starts at around 12-14 weeks of gestation and continues later. TSH peak soon after birth due to exposure to colder outside temperature compared to warmer temperature inside the uterus, After 72 hours, TSH stabilize and then it is continue through out life.

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar