Human Chorionic Gonadotropin (hCG) and Thyroid Function in Early Human Pregnancy: Circadian Variation and Evidence for Intrinsic Thyrotropic Activity of hCG*

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Abstract
To explore the diurnal variation and the relationship between serum hCG levels and thyroid function during pregnancy, 26 women with an uncomplicated early pregnancy were studied before and after interruption of pregnancy. The high serum hCG levels in early pregnancy were accompanied by an increase in serum thyroid hormone and a decrease in serum TSH levels. Nevertheless, serum TSH exhibited diurnal variation similar to that in nonpregnant women. The nocturnal surge of TSH exceeded the daytime nadir by 112% and was distinctly different from the normal serum cortisol variation. The diurnal serum T4 and hCG variations were similar to the variation in serum protein concentrations. After pregnancy interruption, serum hCG levels decreased by 95% within 10 days, and TSH levels rose concomitantly from 0.80 to 1.48 mlU/L (P < 0.001). In individual women serum hCG correlated negatively with TSH (r = 0.322; P = 0.005) and positively with free T3 (r = 0.388; P < 0.001). These results suggest that hCG has thyrotropic activity, which, through rises in thyroid hormone levels, suppresses TSH secretion. In this regard, 27,000–128,000 IU hCG correspond to 1 mlU TSH. Pregnancy-induced changes in thyroid function, however, do not affect the circadian TSH rhythm.