Thyroid
Thyroid
PAPER – MAMMALIAN
ENDOCRINOLOGY
TOPIC-Thyroid Gland
• Endocrine Gland: The thyroid is a vital endocrine gland located in the neck, just
below the larynx. It plays a pivotal role in regulating metabolic processes in the
body by releasing thyroid hormones.
• Hormones Produced: The thyroid primarily produces two major hormones:
thyroxine (T4) and triiodothyronine (T3). These hormones are critical for the
regulation of metabolism, energy production, and general bodily functions.
• Metabolic Regulation: Thyroid hormones control the rate at which cells convert
nutrients into energy, thus directly affecting body temperature, energy levels, and
heart rate.
• Growth and Development: In children, thyroid hormones are essential for proper
growth and development, including brain maturation.
• Iodine Requirement: The thyroid uses iodine from the diet to produce thyroid
hormones. Iodine deficiency can result in thyroid dysfunction.
• Thyroid Dysfunction: Disorders such as hypothyroidism (underactive thyroid)
and hyperthyroidism (overactive thyroid) are commonly associated with the
thyroid gland, affecting metabolism and overall health.
• Location and Shape: The thyroid is located in the lower part of the neck, shaped
like a butterfly, with two lobes connected by an isthmus.
• Thyroid and Pituitary Gland Interaction: The secretion of thyroid hormones is
regulated by the hypothalamus and pituitary gland through a feedback loop
involving TSH (thyroid-stimulating hormone).
• Enzyme Activity: Thyroid hormones also influence the activity of enzymes
involved in various biochemical pathways like protein synthesis and glycolysis.
• Body Temperature Regulation: These hormones are involved in regulating the
body’s heat production and maintaining thermal homeostasis.
• Impact on Lipid Metabolism: Thyroid hormones increase lipid catabolism and
help maintain cholesterol levels in the body, influencing cardiovascular health.
• Neurodevelopment: Thyroid hormones are essential for the proper development
of the brain, particularly during fetal and early childhood stages.
• Immune System Effects: Thyroid dysfunction can affect the immune system,
potentially leading to autoimmune thyroid diseases like Hashimoto's thyroiditis
and Graves' disease.
2. Detailed Structure of Thyroid Gland
• Anatomical Location: The thyroid is situated in the anterior part of the neck, just
below the larynx and in front of the trachea. It consists of two lobes, one on either
side of the windpipe, connected by a narrow isthmus.
• Thyroid Follicles: The thyroid gland is primarily made of spherical structures
known as thyroid follicles. These follicles are filled with a colloid substance,
which is crucial for hormone production and storage.
• Thyroid Follicular Cells: The walls of the follicles are lined with thyroid
follicular cells. These cells are responsible for producing thyroid hormones,
namely T4 and T3, from iodinated tyrosine residues in the colloid.
• Parafollicular Cells (C-cells): Located between the follicles, C-cells secrete
calcitonin, a hormone that plays a role in regulating calcium levels in the body.
• Capillaries and Blood Flow: The thyroid is richly supplied with blood vessels,
which bring iodine and other nutrients necessary for hormone production. The
blood supply is primarily through the superior and inferior thyroid arteries.
• Thyroid Capsule: The gland is enclosed by a fibrous capsule that provides
structural integrity and separates it from surrounding tissues.
• Lymphatic Drainage: The thyroid has its own network of lymphatic vessels that
drain into nearby lymph nodes, playing a role in immune surveillance.
• Cellular Activity: The follicular cells in the thyroid are responsible for the uptake
of iodine, which is essential for thyroid hormone synthesis. They actively
transport iodine from the bloodstream into the colloid.
• Secretion Pathway: Once synthesized, thyroid hormones are stored in the colloid
until the body signals the need for their release, typically through a negative
feedback loop involving TSH.
• Thyroid Hormone Synthesis: The thyroid uses iodine, along with tyrosine, to
synthesize thyroid hormones within the colloid. These hormones are stored in the
gland and released as needed.
• Size and Variation: The size and shape of the thyroid can vary between
individuals. In some cases, such as iodine deficiency, the gland can become
enlarged, leading to a condition called goiter.
• Thyroid Lymphatic System: The thyroid's lymphatic system helps in draining
excess fluids and monitoring the presence of potential pathogens or abnormal
cells.
• Structural Adaptation to Function: The structure of the thyroid is designed to
maximize iodine uptake and hormone production, ensuring that the body's
metabolic needs are met efficiently.
• Intercellular Communication: Follicular cells communicate with one another
through gap junctions, ensuring synchronized hormone production and release.
• Hormone Storage: The colloid within the thyroid follicles serves as a storage
medium for thyroid hormones in their precursor form until they are required by
the body.
3. Biosynthesis of Thyroid Hormones
• Iodine Uptake: The process begins with the active transport of iodine ions from
the bloodstream into the thyroid follicular cells via the sodium-iodine symporter
(NIS).
• Oxidation of Iodine: Once inside the follicular cells, iodine is transported into
the colloid, where it is oxidized by the enzyme thyroid peroxidase (TPO).
• Iodination of Tyrosine: The oxidized iodine is then bound to tyrosine residues in
thyroglobulin, a large protein synthesized by follicular cells. This forms
monoiodotyrosine (MIT) and diiodotyrosine (DIT).
• Coupling of MIT and DIT: Two molecules of DIT or one molecule of MIT and
DIT are coupled to form the thyroid hormones: T4 (thyroxine) and T3
(triiodothyronine).
• Thyroglobulin Storage: The iodinated tyrosine residues remain bound to
thyroglobulin, which is stored in the colloid until needed by the body.
• Release of Hormones: When the body signals the need for thyroid hormones,
thyroglobulin is reabsorbed into the follicular cells, and enzymes break it down to
release T3 and T4 into the bloodstream.
• Deiodination: T4, the more abundant form, is converted into the more active T3
in peripheral tissues through the process of deiodination, facilitated by the enzyme
deiodinase.
• Hormone Secretion Regulation: The production and release of thyroid
hormones are regulated by the hypothalamus and pituitary gland. TSH stimulates
the thyroid to release hormones.
• Iodine Deficiency and Hormone Synthesis: A lack of iodine in the diet can
impair the thyroid’s ability to produce T3 and T4, leading to hypothyroidism and
goiter.
• Thyroid Peroxidase Role: Thyroid peroxidase is key in catalyzing the iodination
of tyrosine residues, a crucial step in the biosynthesis of thyroid hormones.
• Feedback Mechanism: High levels of T3 and T4 in the blood provide negative
feedback to the hypothalamus and pituitary, reducing TSH secretion.
• Importance of Tyrosine: Tyrosine, an amino acid, is essential for thyroid
hormone synthesis. It is part of the thyroglobulin protein and is iodinated to form
T3 and T4.
• Thyroid Hormone Storage: The thyroid gland stores sufficient quantities of T3
and T4 in thyroglobulin form to meet the body’s needs for several days.
• Thyroid Enzyme Deficiencies: Deficiencies in enzymes such as thyroid
peroxidase can lead to impaired thyroid hormone synthesis, resulting in thyroid
dysfunction.
• Regulation of Iodine Utilization: The thyroid efficiently regulates iodine uptake
to ensure sufficient hormone production, adjusting its activity according to dietary
iodine availability.
4. Control of Secretion of Thyroid Hormones
• Binding to Plasma Proteins: The majority of thyroid hormones (T3 and T4) are
bound to plasma proteins such as thyroxine-binding globulin (TBG), transthyretin
(TTR), and albumin, which prevent them from being quickly metabolized or
excreted.
• Thyroxine-Binding Globulin (TBG): TBG is the main protein responsible for
binding T4 and, to a lesser extent, T3 in the bloodstream. About 70-80% of T4 in
circulation is bound to TBG.
• Free Hormones: A small proportion of thyroid hormones in the bloodstream is
unbound, known as free T3 and free T4. These free hormones are biologically
active and can enter cells to regulate metabolism.
• Role of Transthyretin (TTR): Transthyretin (previously called prealbumin) also
binds thyroid hormones in the blood, contributing to their transport and storage in
tissues.
• Albumin’s Role: Albumin, a common plasma protein, has a lesser affinity for
thyroid hormones but still helps in their transport through the bloodstream.
• Cellular Uptake: The free fraction of thyroid hormones enters target cells
through specific transporters on the cell membrane, such as the monocarboxylate
transporter (MCT8).
• Conversion of T4 to T3: Once inside the target cells, T4 is converted into the
more active form, T3, through the action of deiodinase enzymes.
• T3 and T4 Receptors: Once inside the cell, thyroid hormones bind to thyroid
hormone receptors in the nucleus, regulating gene expression and influencing
various metabolic processes.
• Transport to Target Tissues: Thyroid hormones circulate in the bloodstream and
are transported to tissues such as the heart, liver, muscles, and brain, where they
exert their effects on metabolism.
• Iodine Transport: Iodine is transported from the blood to the thyroid gland,
where it is used to produce thyroid hormones. Inadequate iodine leads to reduced
hormone production.
• Transport and Pregnancy: During pregnancy, thyroid hormone transport is
affected by changes in plasma proteins, which can lead to fluctuations in thyroid
hormone levels and adjustments in the fetal thyroid gland.
• Changes in Binding Proteins: Factors like pregnancy, estrogen therapy, and liver
disease can alter the levels of binding proteins, affecting the total thyroid hormone
levels in the blood.
• Thyroid Hormone Transport Disorders: In some conditions, such as familial
dysalbuminemic hyperthyroxinemia, defects in thyroid hormone-binding proteins
can lead to abnormal thyroid function and hormone levels.
• Tissue Specificity: Different tissues in the body may have varying levels of
thyroid hormone receptors and transporters, influencing how responsive they are
to thyroid hormones.
• Plasma Half-life: The plasma half-life of T4 is longer than that of T3 due to its
higher binding affinity to proteins, meaning T4 remains in circulation longer.
6. Denaturation of Thyroid Hormones
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7. Physiological Roles of Thyroid Hormones
• Goiter Formation: Excess thyroid hormones often lead to the enlargement of the
thyroid gland, known as a goiter, which occurs due to overstimulation of the
thyroid tissue by TSH or abnormal thyroid hormone levels.
• Thyroid Hyperplasia: In cases of hyperthyroidism, the thyroid gland undergoes
hyperplasia, leading to an increase in the number of thyroid follicular cells.
• Cardiac Hypertrophy: Chronic excess thyroid hormone can lead to cardiac
hypertrophy, where the heart muscles thicken as a compensatory response to the
increased metabolic demand.
• Skeletal Muscle Weakness: Hyperthyroidism can cause muscle wasting and
weakness due to increased protein catabolism, resulting in a reduction of muscle
mass.
• Weight Loss: Despite an increased appetite, individuals with excess thyroid
hormones may experience weight loss due to the elevated metabolic rate.
• Nervous System Alterations: The nervous system becomes hyper-excitable,
leading to symptoms like irritability, anxiety, tremors, and in severe cases,
psychiatric manifestations.
• Exophthalmos: In conditions like Graves' disease, excessive thyroid hormones
can lead to the bulging of the eyes, known as exophthalmos, due to inflammation
of the tissues behind the eyes.
• Skin Changes: Excess thyroid hormones can lead to thinning of the skin and
increased perspiration. The skin may also appear warm and moist.
• Bone Fragility: Chronic hyperthyroidism can lead to osteoporosis as a result of
increased bone resorption, making bones more fragile and prone to fractures.
• Hair and Nail Changes: There may be thinning or shedding of hair, as well as
brittle nails, due to the hypermetabolic state of the body.
• Gastrointestinal Motility: Hyperthyroidism can increase the motility of the
gastrointestinal tract, leading to diarrhea and frequent bowel movements.
• Menstrual Irregularities: Excessive thyroid hormones can lead to irregularities
in menstrual cycles, often resulting in lighter or shorter periods, or even
amenorrhea (absence of menstruation).
• Increased Sweating: Excessive sweating, especially during rest or minimal
exertion, is a common symptom of hyperthyroidism due to an elevated metabolic
rate.
• Respiratory Changes: Increased respiratory rate (tachypnea) may occur as the
body tries to meet its higher oxygen demands due to the hypermetabolic state.
9. Morphological Consequences of Deficiency of Thyroid
Hormones