Some causes of decreased TBG include nephrotic syndrome, cirrhosis of the liver,
hereditary or idiopathic TBG deficiency, acromegaly, testosterone-producing
tumors, severe acidosis, androgens, and glucocorticoids,
Some causes of increased TBG include
estrogen (pregnancy, oral contraceptives, and estrogen-producing tumors),
acute liver disease, systemic illness ,acute intermittent porphyria, lymphocytic
painless subacute thyroiditis, hereditary or idiopathic TBG excess, and
medications such as methadone, heroin, perphenazine, and clofibrate,
Thyroid binding globulin (TBG) levels rise during pregnancy in response
to elevated estrogen levels. Because the majority of T4 and T3 circulates bound to TBG
the total T4 and total T3 measurements will also rise, but the levels of free T4
and free T3 will not be affected.
References:
1. Lockitch G. Handbook of Diagnostic Biochemistry and
Hematology in Normal Pregnancy. Boca Raton:CRC, 1993.
2. Kratz A, Ferraro M, Sluss PM,
Lewandrowski KB. Laboratory reference values. N Engl J Med.
2004;351(15):1548-15632. PMID:15470219
3. Brent GA.Maternal thyroid function: interpretation of thyroid function tests
in pregnancy. Clin Obstet Gynecol. 1997 Mar;40(1):3-15.
PMID: 9103946
4. Fischbach FT, Dunning MB III, eds.
A Manual of Laboratory and Diagnostic Tests, 7th ed. Philadelphia,
Lippincott Williams and Wilkins,2004