Thyroid  rT3

- 1%
Thyroid Gland - 3, 3’, 5’-triiodothyronine
 Thyroid follicles  Metabolism and excretion
- Acinus - Deiodination, deamination, glucoronic acid
- Colloid conjugation
o Thyroglobulin - Liver, Kidneys
o T4, T3, rT3 o Bile, Feces
 Parafollicular C cells o Urine
- Calcitonin - I2: 150μg/day, 1mg/week
Thyroid Hormone - Hypothyroid
 Activates nuclear transcription - Euthyroid
-  functional activity of cells - Hyperthyroid
Thyroid Hormone Synthesis Actions of Thyroid Hormone
 Iodide trapping  Thyroid hormone receptor family
- NIS  BMR
 Oxidation of iodide to I2 - M: 30-40 Kcal/m2, F: 27-36 Kcal/m2
- Thyroid peroxidase enzyme -  mitochondria, enzymes for oxidative
 Iodination of tyrosyl residues phosphorylation
- MIT, DIT -  Na-K pump
- Thyroid peroxidase enzyme - Thermogenic effect
 Coupling - All cells except gonads, uterus, lymph nodes,
- T4, T3, rT3 spleen, adenohypophysis, thymus, lungs,
- Thyroid peroxidase enzyme dermis, accessory sex organ
 Exocytosis  Growth
- Thyroid protease, peptidase - GH, somatomedin
- Deiodenase - Bone maturation, ossification, fusion of growth
Thyroid Hormone Transport plates
 99.95% T4 is bound  CNS
- Thyroxine binding globulin - Maturation, myelinization, neuronal
- Thyroxine binding prealbumin arborization
- Thyroxine binding albumin - Mental excitability
 99.5% T3 is bound  ANS
- Thyroxine binding globulin - Potentiates β–adrenergic effects
- Thyroxine binding albumin  Cardiovascular, respiratory effects
Thyroid Hormone Activation -  HR, CO, BP, RR, ventilation
 Peripheral activation  GIT
- Deiodinase -  motility, secretion, absorption
o T4  T3, rT3 -  glucose absorption
Thyroid Hormone  Skin
 T4 -  heat production, sweating, cutaneous
- 90% vasodilation
- 3, 5, 3’, 5’-tetraiodothyronine  Lactogenesis and pregnancy
- Thyroxine  CHO metabolism
- 80% T4  T3 - Potentiates action of insulin
- 5’-deiodinase o Promotes glycogenesis, glucose utilization
- T1/2: 6-7 days - Potentiates action of epinephrine
 T3 o Promotes glycogenolysis, gluconeogenesis
- 10%  CHON metabolism
- 3, 5, 3’-triiodothyronine - Anabolic effect
- Liver, kidneys, skeletal muscle, brain  Fat metabolism
- T1/2: <4 days - Promotes lipid synthesis, mobilization,
- 3-5 x more active utilization
 -Lipolysis > lipogenesis  Stage Ia
- thyroid hormone level  TAG, cholesterol, - Palpable, not visible
phospholipids,  free fatty acids  Stage Ib
 Vit metabolism - Palpable
-  vit requirements - Visible when neck is extended
- Potentiates  Stage II
o Carotene  vit A - Visible when near
o Vit A  retinene  Stage III
Regulation of Thyroid Function - Visible when far

Hypothalamus  Hypothyroidism

Anterior pituitary 1O 2O Cretinism

Thyroid
 T3, T4  T3, T4 Congenital
 Estrogen:  TSH  TSH  TSH hypothyroidism
 Somatostatin:  TSH, anterior pituitary response
to TRH
 Dopamine, dopa, bromocriptine:  TSH
 I2:  T3, T4 - Somnolence, sluggish, slow speech, slow
- Wolff-Chaikoff effect movements
- Wolff-Chaikoff escape - Bradycardia, arteriosclerosis
 Thyroid autoregulation - Constipation
-  iodine, T3, T4:  I2 uptake - Cold intolerance,  sweating, cold, dry skin
-  I2:  T3, T4 release - Dull hair
 Thyroid stimulating Ig + TSH receptors:  T3, T4 o Myxedema
- Grave’s disease - 1o or 2o amenorrhea
Abnormalities in Thyroid Function Hypothyroidism
 Anatomic disorders Cretinism
- Goiter Congenital or endemic
 Functional disorders Sluggish movements, weakness
- Hypothyroidism Mental retardation, reduced myelination, reduced
- Hyperthyroidism branching of neurons
Goiter: diffuse or Enlargement of soft tissues
nodular Short stature
Guttural breathing
Hypothyroid Non-toxic goiter Hyperthyroidism
Nervousness, irritability, fine tremors, insomnia
Euthyroid Non-toxic goiter Tachycardia, palpitations, systolic hypertension
Hyperthyroid Toxic goiter Diarrhea
Muscle weakness, atrophy, osteoporosis
 Goitrogens Heat intolerance,  sweating
-  T3, T4 synthesis Pretibial myxedema, exopthalmos
-  TSH Hyperthyroidism
- Perchlorate, thiocyanate, pertechnitate Hyperthyroidism
- Thioamides, PTU, methimazole Thyroid scan
- Iodine deficiency Nodular Goiter
- Cassava, cabbage, mustard, turnip Hot nodule
Functioning nodule, benign
WHO Classification of Goiter Cold nodule
 Stage 0 Non-functioning nodule, malignant
- No goiter Signs and Symptoms
Calcitonin
Calcitonin
Parafolicular C cells, parathyroid gland, thymus
Ca and PO4 homeostasis
 serum Ca, PO4
GIT:  intestinal Ca absorption
Bone:  osteoclastic activity
Kidneys:  Ca, PO4 reabsorption
Calcitonin
GIT
 Ca, PO4 absorption
 gastric motility, secretion
 intestinal secretion
Prevents post-prandial hypercalcemia
Kidneys
 Na, Ca, PO4 clearances
 PO4 reabsorption in the PCT
 Ca extrusion from the cells
 1 α-hydroxylase activity
Calcitonin
Bone
Protects against Ca loss
Pregnancy, lactation
 osteoclastic activity, bone resorption
 serum Ca
 collagen destruction
 citrate production
 alkaline phosphatase in osteoblasts
Other effects
Vit D regulation
Regulates feeding and appetite
Calcitonin
 seum Ca:  calcitonin
Food ingestion:  calcitonin
Gastrin, CCK, enteroglucagon mediated
Protects bones from excessive resorption during dietary
sufficiency
end
He told me that I had a soul. How does he know?
What spirit comes to move my life? Is there another
way to go?
-Les Miserables