The Thyroid

Gland
Dr. Nejmudin
Thyroid Gland
• Lies in the neck region
anterior to the trachea.
• Consists of 2 lobes one
on either side of the
trachea joined by an
isthmus.
• Occasional pyramidal
lobe
• When enlarged it moves
with swallowing
Microscopic structure
• made up of a large
number of
encysted follicles
lined up by
cuboidal cells
• Wall of follicles is
single layer and
filled with colloid
Microscopic structure
• When active the
cells are columnar
with small follicles.
• when inactive the
cells are flattened
with large follicles.
• Para follicular cells are found between
follicles,
• they secrete Calcitonin→ Ca2+ homeostasis.
 Thyroid Gland
 Hormones secreted by thyroid gland:
1) Thyroxine, T4
2) Tri-iodothyronine, T3
3) Calcitonin
 Formation of thyroid
hormone:
• Needs iodine.
• Iodine is found in food, drinking water &
table salt.
• The minimum requirement is about 100-150
μgm /day.
• Iodide is absorbed into blood
 Iodide trapping:
• 50% of the absrobed iodide is trapped by
iodide pump in thyroid cells,
• rest is excreted in urine.
• The thyroid removes iodide from blood
against concentration gradient.
• The thyroid cells have a RMP of –50mV,
• Iodide is pumped against electrical and
concentration gradient.
Thyroglobulin
• Thyroglobulin is a large protein synthesized
by the endo­plasmic reticulum of the thyroid
cells and secreted into the colloid
• It has molecules of the amino acid tyrosine,
used for thyroid hormone synthesis.
• The synthesis of thyroid hormones takes
place within the thyroglobulin molecules in
the colloid.
synthesis of thyroid hormone
1-The first step: is oxidation of iodide into iodine by
peroxidase enzyme
2- Iodine combines with tyrosine in the surface of
thyroglobulin → monoiodotyrosine (MIT) & diodotyrosine
(DIT).
• This occurs rapidly as the thyroglobulin is moving from
cell to colloid into follicle.
3- Coupling of MIT & DIT → triiodothyronine (T3) &
• coupling of two DIT → tetraiodothyronine (T4) or
thyroxin.
• This is a relatively slow process.
• T3 and T4 are fixed to thyroglobulin by peptide linkages.
• All 4 products (MIT, DIT,T3 and T4 ) are found in
the surface of the thyroglobulin in the colloid
4-Thyroglobulin then goes into cell by pinocytosis.
• Inactive Proteolytic enzymes are present in
thyroid cell,
• when activated release all 4 products from
thyroglobulin (T3, T4, MIT, DIT)
• These products leave the cell to the circulation
by concentration gradient.
• Deiodinase is an enzyme in the thyroid
cell that removes iodine from MIT and DIT
but not from T3 or T4.
• The iodine is then reused for formation of
new thyroid hormones.
 SUMMARY
• Iodide is actively transported into the follicular
cells.
• In the colloid, it is oxidized → iodine
• attached to tyrosine within the thyroglobulin
protein.
• Coupling of MIT & DIT → T3 & T4
• Upon stimulation by TSH, the thyroid hormones,
bound to thyroglobulin, are taken into the
follicular cells by pinocytosis.
• Hydrolysis reactions within the follicular cells
release the free T4 & T3.
 Transport of thyroid
hormone:
• When T3 & T4 enter the blood they combine
with proteins :
1) albumin,
2) thyroid binding pre-albumin (TBPA)
3) thyroid binding globulin (TBG).
• T4 has much more affinity to combine with
protein than T3.
• Only very small amounts of T3 & T4 are found
free in plasma.
• 99.98% of T4 & 99.8% of T3 are bound to
protein
 between
T3 & T4:
1) The thyroid gland secretes much larger
amounts of T4 than T3.
2) T4 has much greater affinity for protein so it is
more stable in the body.
3) T4 is an extracellular hormone whilst T3
penetrates cells readily.
4) T4 is very largely converted to T3 in the body.
(act as a precursor for T3).
5) T3 is quicker acting & more potent than T4 in
isolated tissues
• The purpose of binding to proteins is:
1) To ensure even distribution of the
hormone (the hormone is lipid soluble it
can enter into the first tissue that it meets
after release)
2) To have a reserve of the hormone in the
circulation to be released when needed.
3) Not to be lost in urine.
 Hormone turnover
 T4 half life 6.7 days

 T3 half life 1.3 days

 Mechanism of Action:
 Thyroxin and Tri-iodothyronine enter the
cell.
 Most of T4 is changed to T3 in the

cytoplasm.
 They bind to receptors inside the nucleus.
 They induce formation of mRNA

 Which affect proteins synthesis

Control of
secretion

Thyrotropin releasing hormone (TRH)

Thyroid stimulating hormone

+
T4

Dr. Amal Mahmoud Saeed 06/07/2025 03:55 PM

 TSH
• TSH receptor on thyroid cell.
• It works through cAMP.
Effects of TSH
1) Stimulate synthesis & secretion of T3
&T4.
2) increases blood flow to gland.
3) Thyroid gland hypertrophy
 Functions of thyroid
hormone:
 Main Functions
1. Calorigenic & metabolic effects.
2. Growth & development.
3. Nervous system development and
function.
 A-Calorigenesis
(heat production) :
• is the primary function of thyroid hormone.
• ↑rate of heat production

• ↑ rate of O2 consumption by tissues

• Exceptions are adult brain, spleen, uterus, ovaries
and testis is not affected.
• The increased O2 consumption is due to ↑ Na+-K+
ATPase activity & ↑ mitochondrial protein
synthesis.
 B- Effect On Growth &
Development
 T3 & T4 are essential for the growth and skeletal
maturation.
– In hypothyroid infants (cretins): bone growth
slowed and epiphyseal closure is delayed.
 GH secretion is decreased in the absence of T 3
& T4
 Thyroid hormone potentiates the effect of GH on
tissues.
 Effect on protein
metabolism:
• In physiological doses →↑protein
synthesis
• but in large doses →↑ protein
breakdown because of increased O2
consumption.
• Deficiency of thyroid H early in life →
growth retardation resulting in
cretinism.
 Effect on Carbohydrate
metabolism:
• Thyroid H increases blood glucose level
(hyperglycaemia) by the following
mechanisms:
1) ↑ appetite.
2) ↑ absorption of glucose from GIT.
3) Stimulate Glycogenolysis &
gluconeogenesis.
4) Causes degradation of insulin.
 Effects on lipid
metabolism:
1) Causes lipid breakdown → free FA
are used for energy.
2) Decreases serum cholesterol
as it ↑LDL receptors in liver cells
so it is removed from the circulation
 Effect on vitamins:
• It increases the demand for
vitamins .
• Conversion of carotene into vitamin A
 C-Effect on CNS
1) Acts on synapses of CNS, so increasing
excitability.
2) In children it has marked effects on brain
development (branching of axons,
myelination in foetus & infants),
• Cretin is characterized by mental
retardation as distinct from a dwarf.
• The hormone enter brain in adults, the
brain converts T4 to T3.
1. In infants:-

• hypothyroidism synapses develops abnormally,

myelination is defective & mental development is

retarded.

2. adults:-

• Hypothyroidism slow mentation

• Hyperthyroidism anxiety

• The mechanism may be through potentiating the action

of catecholamines.
 Effects on body
systems:
CVS:-
• T3 and T4 increase the number and affinity
of B- receptor in the heart so it :
-↑HR.
- ↑ force of contraction of cardiac muscle.
- ↑ COP.
↑ in Systolic BP
• ↓ peripheral resistance due to:
· Vasodilatation in skin to increase heat
loss.
· Vasodilatation at tissues due to
increase in metabolism

↓ in diastolic BP
• ↑Pulse pressure.

• known as collapsing pulse

Respiration:
• Increased O2 consumption & CO2
production → ↑rate & depth of
breathing.
 Effect on GIT
• ↑ appetite,
• ↑ absorption of food,
• ↑ production of digestive juices and
motility.
 In hyperthyroidism→Diarrhoea
 In hypothyroidism→ Constipation
 Skeletal muscle:
• Muscle weakness in hyperthyroidism is
due to:
1. increased protein catabolism.
2. disturbed water & electrolyte metabolism
3. continuous stimulation of CNS by the
hormone causing a fine tremor & thus
depletion of energy reserves.
 Blood:
• Moderate anaemia occurs in deficiency of
thyroid H due to:
• decreased bone marrow metabolism
• and poor absorption of vitamin B12.
• This can only be corrected by thyroid
hormone administration
 Reproductive organs:
• The hormone is important for normal
development and function of the gonads.
• Hypothyroidism → impairment of fertility &
increased menstrual bleeding
• Hyperthyroidism → ↓ or absent menstrual
bleeding.
 Thyroid Function
Test
 General tests:

• BMR (not used).

– In hyperthyroidism → increased to 100%
– in hypothyroidism → decreased to 30 –40% of
normal.
• Plasma Cholesterol Level.
– High in hypothyroidism.
 Thyroid Function
Test
 Specific Tests:
1-Plasma T3 and T4 and TSH estimation.
2- Radio-active iodine uptake:
↑in hyper-thyroidisim ,
↓in hypo-thyroidisim
3-Thyroid Scan:
- Localization of sites & intensity of
radioactivity in thyroid gland.