Thyroid Hormones

K.Ramachandran
M.Sc. Medical Biochemistry
SRM Medical college
Anatomy of the Thyroid Gland
Histology of thyroid gland
 Thyroid hormones
• Thyroxin (T4, tetraiodothyronine)

• Tri-iodothyronine (T3)

• calcitonin
Structure of thyroid hormones
 Biosynthesis of thyroid hormones
The process includes
• active uptake of iodide from the plasma (iodide
pump)
• Oxidation of I- and iodination of thyroglobulin (Tg)
tyrosine residues
• Coupling of iodotyrosine residues (MIT and DIT)
to form T4 and T3
• Proteolysis of Tg with release of T4 and T3 into the
circulation
Synthesis and secretion of thyroid
hormones
Regulation of thyroid hormones
Adult Reference Ranges:
• T4 = 5.6-13.7 ug/dl
• FT4 = 0.8-1.5 ng/dl
• T3= 87-180 ng/dl
• FT3 = 230-420 pg/dl
• TSH = 0.4-4.5 mIU/L
 Carriers for Circulating Thyroid
Hormones
• More than 99% of circulating T4 and T3 is bound to
plasma carrier proteins
– Thyroxine-binding globulin (TBG), binds about 75%
– Transthyretin (TTR), also called thyroxine-binding
prealbumin (TBPA), binds about 10%-15%
– Albumin binds about 7%
• Only ~0.02% of the total T4 in blood is unbound or free.
• Only ~0.4% of total T3 in blood is free
 Thyroid Hormones Stimulate
Metabolic Activities in Most
Tissues
• Thyroid hormones (specifically T3) regulate
rate of overall body metabolism
– T3 increases basal metabolic rate
• Calorigenic effects
– T3 increases oxygen consumption by most
peripheral tissues
– Increases body heat production
 Metabolic Effects of T3
Carbohydrate metabolism :

• Increases absorption of glucose from GIT

• Enhances the glucose uptake by cells

• Increases glycogenolysis

• Accelerate gluconeogenesis
Lipid metabolism
• Stimulates lipolysis and release of free fatty
acids and glycerol
• Induces expression of lipogenic enzymes
• Decreases cholesterol in plasma by Stimulates
metabolism of cholesterol to bile acids
• Facilitates rapid removal of LDL from plasma
Protein metabolism
• Increases the synthesis of protein in the cells
 Effects Of Thyroid Hormones On
The Cardiovascular System
• Increase heart rate

• Increase force of cardiac contractions

• Increase stroke volume

• Increase Cardiac output

 Effects Of The Thyroid Hormones
In Growth And Tissue
Development
• Increase growth and maturation of bone

• Increase tooth development and eruption

• Increase growth and maturation of epidermis,hair

follicles and nails
• Increase rate and force of skeletal muscle contraction

• Inhibits synthesis and increases degradation of

mucopolysaccharides in subcutaneous tissue
 Effects Of The Thyroid Hormones
On The Nervous System
• normal CNS neuronal development

• Enhances wakefulness and alertness

• Enhances memory and learning capacity

• Required for normal emotional tone

• Increase speed and amplitude of peripheral nerve

reflexes
Effects Of The Thyroid Hormones
On The Reproductive System
• Required for normal follicular development
and ovulation in the female

• Required for the normal maintenance of

pregnancy

• Required for normal spermatogenesis in the

male
Overview of Thyroid Disease
States
• Hypothyroidism

• Hyperthyroidism
 Hypothyroidism
Hypothyroidism is a disorder with multiple causes
in which the thyroid fails to secrete an
adequate amount of thyroid hormone
– The most common thyroid disorder

– Usually caused by primary thyroid gland failure

– Also may result from diminished stimulation of

the thyroid gland by TSH
 Cretinism

- congential absence of T3 and T4 or chronic

iodine deficiency during childhood

- retarded growth

- sluggish movements

- mental deficiencies
Congenital Hypothyroidism
 Myxoedema
• adult hypothyroidism

- low rate of metabolism and lethargy

- decreased body temp

- decreased heart rate

- outer skin becomes scaley

- swelling of sub-cu connective tissues

 Clinical Features of
Hypothyroidism
• Tiredness
• Forgotfullness
• Weight gain
• Cold intolerance
• Dry,patches skin
• Menstrual irregularities
• Infertility
• Constipation
• Muscle weakness,cramps
• Puffy eyes
Weight Ga
 Hyperthyroidism
• Hyperthyroidism refers to excess synthesis and secretion
of thyroid hormones by the thyroid gland, which results
in accelerated metabolism in peripheral tissues

causes for hyperthyroidism :

Graves disease:
Most common
Autoimmune disease
Thyroid stimulating autoantibodies produced by
plasma cells
Activate TSH receptors,
I ncrease thyroid hormone secretion
 Signs and Symptoms of
Hyperthyroidism
• Heat intolerance
• Weight loss
• Tachycardia
• Mental disturbance
• Irritability
• Nervousness
• Difficult in sleeping
• Exophthalmos
• Muscular weakness
Hyperthyroid
 Thyroid Hormone Levels in
Thyroid Disease
TSH T4 T3
Hypothyroidism High Low Low

Hyperthyroidism Low High High

 Goiter

• swelling in neck
• both hypo- and hyperthyroidism
 Thyroid Function Tests
• TSH
• Thyroxine (T4)
• Ttriiodothyronine (T3)
• Thyroid Antibodies
Imaging
Thyroid Ultrasound scan
Thyroid Isotope Scan
 Treatment for thyroid disorders
Treatment for hyperthyroidism :
• Antithyroid substances:
• Thyiocyanate
• Thiourylenes
• Surgical removal of thyroid gland
• High concentration of inorganic iodides

Treatment for hypothyroidism :

• Administration of thyroxine in the form of
tablets orally
Thank you