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Thyroxine-Binding Globulin in Serum and Milk Specimens from Puerperal Lactating Women

Department of Obstetrics and Gynecology, Albert Einstein Medical Center, Northern Division, Philadelphia, Pennsylvania.

The whey fraction of human milk contains a thyroxine-binding protein analogous to serum thyroxine-binding globulin. To assess the method by which this binding protein appears in milk over the course of lactation, paired serum and milk specimens from 45 healthy, euthyroid women were assayed for thyroxine-binding globulin and whey thyroxine-binding globulin using a highly specific thyroxine-binding globulin-radioimmunoassay. Elevated serum levels (39.2 ± 4.72 µg thyroxine-binding globulin/mL; mean + SD, N = 5) were found in samples drawn at less than two weeks post partum. These levels normalized rapidly over the next three weeks post partum (26.0 ± 3.3 µg/mL, P < .005, N = 5), and by five weeks, no further significant decreases were observed. As was the case for serum thyroxine-binding globulin, whey thyroxine-binding globulin was present in its highest concentrations (79.3 ± 13.4 µg/dL, N = 7) in the colostrum and transitional milk. These levels are equivalent to approximately 2 to 3% of serum concentrations. In contrast to serum thyroxine-binding globulin levels, however, whey thyroxine-binding globulin declined logarithmically over a protracted 12-week period, and no further significant changes in whey thyroxine-binding globulin concentrations were observed up to 20 weeks post partum, at which time they were approximately equal to 1% of serum thyroxine-binding globulin levels. A strong linear correlation between serum and whey thyroxine-binding globulin was found within the first five weeks post partum (r² = .95, P < .0005, N = 14). Subsequent to the puerperium as the time of lactation increased, both postpartum time and serum thyroxine-binding globulin concentrations concomitantly influenced the ultimate levels of whey thyroxine-binding globulin secreted by the breast. These data suggest that circulating serum thyroxine-binding globulin is the source of whey thyroxine-binding globulin.