Escolar Documentos
Profissional Documentos
Cultura Documentos
T3
T4
The HPT axis
• TSH stimulates the uptake of
iodide, and all other processes
that promote formation and
release of T4 and T3
• TSH activates adenylcyclase
bound to the cell membranes of
the follicular cells and increases
their cAMP.
• T3 has a strong inhibitory effect
on TRH secretion, as well as on
the expression of the gene for
the TRH precursor
Thyronine Binding Globulin (TBG)
• Both T3 and T4 are released from the thyroid, but
much more T4 is produced than T3. When released
into the circulation, they combine with plasma
proteins, mainly Thyronine Binding Globulin (TBG)
• In the blood we have only small amounts of
thyroxine-binding globulin, but the affinity for T4 is
high.
▫ total T4 is 10-7 mol per l equal to 77.7 g per l of blood
serum, because 777 g of T4 equals one mol.
• Approximately 70% of T4 and T3 binds to TBG, and
the rest to thyroxine-binding albumin (TBA) and to
transthyrenin. Oestrogens stimulate the synthesis of
TBG.
T3 and T4
• In the peripheral tissues, T4 is converted into the
more active iodothyronine T3.
• This is brought about by a deiodination reaction.
T3 is a more potent hormone than T4 but it has a
shorter half-life.
• ( T3: 24hrs/ T4: 7 days)
Reverse T3
• There is another important conversion in the periphery
where T4 is deiodinated to an inactive iodothyronine
called reverse T3 (rT3). The precise role of rT3 is not fully
understood, but it is thought to regulate the amount of
active iodothyronines in the periphery.
Actions of thyroid hormones
• Lipid-soluble and pass through • Stimulates oxygen consumption
cell membranes easily in almost all cells
• Cellular constituents are • Stimulates the rate of
stimulated by T3 ▫ Hepatic glucose output and
▫ Mitochondria peripheral glucose utilisation
▫ Na+ - K+ pump ▫ Hepatic matabolism of fatty
▫ Myosin ATPase acids, cholesterol and
▫ Adrenergin B-receptors triglycerides
▫ Many enzyme systems and ▫ Synthesis of important proteins
proteins for growth and ▫ Absorption of carbohydrates in
maturation including CNS the intestine and the gut
development excretion of cholesterol
▫ Modulation of reproductive
function
Actions of Thyroid Hormones
• Stimulates the overall increase
in oxygen consumption
▫ Slow, but long lasting
calorigenic and thermogenic
effect is confined to the
mitochondria
• Thyroid hormones and the
catecholamines work together in
metabolic acceleration
• Thyroid hormones increase
cardiac rate and output as well
as ventilation
Parathyroid Gland
• four tiny glands located within
the thyroid gland
• Produces parathyroid hormone
(PTH) that helps control the
amount of calcium in the blood.
Parathyroid Gland
• Calcium-sensing proteins in the
parathyroid glands sense serum
calcium levels.
• In response to slight declines in
serum calcium, the parathyroid
glands secrete parathyroid
hormone (PTH).
• PTH stimulates the activity of
the 1-hydroxylase enzyme in the
kidney, resulting in increased
production of calcitriol, the
biologically active form of
vitamin D.
Parathyroid Gland
• Calcitriol activates the vitamin
D-dependent transport system
in the small intestine, increasing
the absorption of dietary
calcium and phosphorus.
• Calcitriol and PTH act on the
skeleton to increase the
mobilization of calcium and
phosphorus into the circulation.
• In the kidneys, calcitriol and
PTH increase calcium
reabsorption and increase
phosphorus excretion.
Thyroid Disorders
• Hypothyrodism
▫ Fatigue or lack of energy
▫ Weight gain
▫ Feeling cold
▫ Dry skin and hair
▫ Heavy menstrual periods
▫ Constipation
▫ Slowed thinking
• The most common cause of
hypothyroidism is Hashimoto's
thyroiditis. In this condition,
the body's immune system
mistakenly attacks the thyroid
gland
Thyroid Disorders
• Hyperthyroidism
▫ Jitteriness, shaking, increased
nervousness, irritability
▫ Rapid heart beat or
palpitations
▫ Feeling hot
▫ Weight loss
▫ Fatigue, feeling exhausted
▫ More frequent bowel
movements
▫ Shorter or lighter menstrual
periods
Thyroid Disorders
• Graves Disease
▫ increased metabolic rate and
sympatho-adrenergic
activity dominate the patient
▫ anxious with warm and
sweaty skin, tachycardia,
palpitations, fine finger
tremor, and pretibial
myxoedema
▫ Typically is a symmetrical,
warm pulsating goitre
▫ The cardiac output is high
even at rest and arrhythmias
are frequent