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SERPINA7 gene
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Gene

SERPINA7 gene

The SERPINA7 gene provides instructions for making thyroxine-binding globulin, a protein that transports thyroid hormones through the bloodstream.

Normal Function

The SERPINA7 gene provides instructions for making a protein called thyroxine-binding globulin. This protein attaches (binds) to hormones produced by the thyroid gland, which are essential for regulating growth, brain development, and metabolism. In the bloodstream, thyroid hormones are typically attached to thyroxine-binding globulin and similar proteins.

Health Conditions Related to Genetic Changes

Inherited thyroxine-binding globulin deficiency

Variants in the SERPINA7 gene can lead to inherited thyroxine-binding globulin deficiency, which typically does not cause health problems. There are two forms:

  • Partial form: Reduces the amount of functioning thyroxine-binding globulin.
  • Complete form: Causes a more significant loss of functioning thyroxine-binding globulin.

Some variants produce a shortened, non-functional protein, while others change a single amino acid, leading to reduced levels. Because this deficiency reduces the total amount of thyroxine in the blood, it can be mistaken for more serious thyroid disorders like hypothyroidism.

Other disorders

Changes involving the SERPINA7 gene can also cause thyroxine-binding globulin excess. This condition is caused by the presence of one or more extra copies of the SERPINA7 gene in each cell, leading to levels two to four times higher than normal. Like the deficiency, this condition typically does not cause health problems.

Other Names for This Gene

  • alpha-1 antiproteinase, antitrypsin
  • serine (or cysteine) proteinase inhibitor, clade A (alpha-1 antiproteinase, antitrypsin), member 7
  • serine (or cysteine) proteinase inhibitor, clade A, member 7
  • serpin peptidase inhibitor, clade A (alpha-1 antiproteinase, antitrypsin), member 7
  • TBG
  • thyroxin-binding globulin
  • thyroxine-binding globulin

Frequently Asked Questions

Understanding SERPINA7 gene variants is crucial because inherited thyroxine-binding globulin (TBG) deficiency or excess can alter total thyroid hormone levels in blood tests. This can lead to a misdiagnosis of more serious thyroid conditions like hypothyroidism or hyperthyroidism, even when your actual thyroid function is normal. Knowing about a SERPINA7 variant helps your doctor interpret your lab results correctly and avoid unnecessary treatments for a non-existent thyroid disorder.
Diagnosis typically involves blood tests to measure the total thyroxine (T4) and triiodothyronine (T3) levels, along with a specific test for thyroxine-binding globulin (TBG) levels. Genetic testing for variants in the SERPINA7 gene can confirm the diagnosis and distinguish it from other thyroid disorders.
Your doctor will look at a combination of tests. If total T4 levels are low but free T4 (the active, unbound hormone) and TSH (thyroid-stimulating hormone) levels are normal, it strongly suggests a TBG deficiency rather than true hypothyroidism. Similarly, high total T4 with normal free T4 and TSH points to TBG excess. Genetic testing for SERPINA7 variants can provide a definitive answer, confirming that the issue is with the transport protein, not the thyroid gland itself.
No, typically no treatment is needed for inherited TBG deficiency or excess because these conditions do not usually cause health problems or affect the amount of active thyroid hormone available to your body's tissues. The main "management" is ensuring healthcare providers are aware of the condition to prevent misdiagnosis and unnecessary treatment for a thyroid disorder.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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