The thyroid gland is one of the largest endocrine

glands, weighing about 20 g in the adult human.

It consists of right & left lobes that lie below the
larynx on either sides of and anterior to the trachea.
The two lobes are connected by a thin tissue known as
isthmus.
It is composed of a large number of follicles, each is
made of a single layer of epithelium (simple cuboidal
epithelium) surrounding a central lumen filled with a
substance called colloid (glycoprotein called
thyroglobulin).
In between the follicles,
there are other cells
called parafollicular cells
which secrete calcitonin
hormone
(polypeptide of 32 amino
acids).
 Thyroid hormones
Folicular cells of thyroid gland secretes two iodine
containing hormones which are:
1- Thyroxine (tetraiodothyronine) (T4)
2- Triiodothyronine (T3)
Synthesis, storage &release of thyroid
hormones
1- Thyroglobulin synthesis:
Thyroglobulin is synthesized within the follicular cells,
then passes into the lumen, where it is stored as a part
of the colloid.
2- Iodide pump:
Iodide (I¯) (the ionic form of iodine) in food and drinking
water is absorbed from the gastrointestinal tract into
the blood, which are then actively transported into
thyroid cells against concentration gradient (iodide
pump).
 Synthesis, storage &release of thyroid
hormones
3- Iodide oxidation: (continue)
Iodides are then diffused into the
lumen, where it is oxidized to iodine .
4- Formation of thyroid hormones:
a- Iodination:
The free iodine is then
attached to tyrosine to form
monoiodotyrosine (MIT). A
further iodination of MIT
gives diiodotyrosine (DIT).
b- Coupling:
The coupling of two iodinated tyrosines.
If DIT + DIT are coupled → T4
But if DIT + MIT are coupled → T3
 Synthesis, storage &release of thyroid
hormones
(continue)
5- Storage of thyroid hormones:
The formed T4 and T3 are then stored in the follicular
lumen and not in the intracellular fluid (in contrast to
other hormones).
Note that, T4 and T3 are not free, but still present as
part of the thyroglobulin molecules.
6- Release of thyroid hormones:
When the follicular cells are stimulated to produce
thyroid hormones (by TSH), a colloid portion
(containing thyroglobulin) is taken into the follicular
cells and broken down by proteolytic enzymes to
produce free T4 and T3, which then diffuse into the
blood stream.
 Notes
The plasma level is about 8 μ g/dl of T4 & about 0.15 μ
g/dl of T3 (with a ratio of T4 to T3 is 50:1).
Thyroxine (T4) is converted to the active T3
Most of the thyroid hormones circulating in the blood
are bound to transport proteins.
Only a very small fraction of the circulating hormone
is free (unbound) and biologically active, hence
measuring concentrations of free thyroid hormones is
of great diagnostic value.
1- Metabolic effects:
Thyroid hormones exert numerous metabolic effects in
almost all tissues of the body.
a- The metabolic rate:
Thyroid hormones increase the basal metabolic rate,
through increasing O2 consumption and heat
production.
b- Carbohydrate metabolism:
Thyroid hormones increase blood glucose
concentration, through stimulation of:
(1) Intestinal glucose absorption,
(2) Glycogenolysis and
(3) Gluconeogenesis.
1- Metabolic effects: (continue)
c- Lipid metabolism:
Thyroid hormones increase lipid mobilization from
adipose tissue (lipolysis) and further increase fatty
acids oxidation.
d- Protein metabolism:
Thyroid hormones (at normal physiological
concentration) increase protein synthesis (anabolic
effect) due to stimulation of mRNA formation.
However, when thyroid hormones are present in
excess, they cause a decrease in protein synthesis and
an increase in protein breakdown, which result in
muscle weakness and body weight loss.
2- Growth effects (physical & mental
activities):
Thyroid hormones are essential for all growth processes
during the early postnatal periods, where adequate
hormone amounts are needed for both:
(a) Physical growth and
(b) Mental development.
This achieved by:
Stimulation of growth hormone secretion by
anterior pituitary gland and
Promotion of IGF-I production by the liver.
3- Other effects:
a- Cardiovascular system:
Increase cardiac output through increasing of the rate
and strength of cardiac contraction.
3- Other effects: (continue)

b- Respiratory system:
Increase the rate and depth of respiration i.e. increase
utilization of oxygen and formation of carbon dioxide.
c- Reproductive system:
Thyroid hormones are necessary for normal
reproductive functions (due to the metabolic effects of
the thyroid hormones).
Also, thyroid hormones increase milk synthesis in
lactating women.
 I- Hypothyroidism (thyroid hypofunction)
A- Cretenism:
If begins after birth and continues throughout
childhood leads to cretinism. This is characterized by:
(1) Reduced skeletal and nervous
maturation, so the cretin individuals may
not exceed one meter in height (dwarf)
(2) Delayed or
stopped of sexual
maturation.
(3) Low metabolic
rate with
increased feeling
of cold and the
cretin is usually
obese.
 I- Hypothyroidism (thyroid hypofunction)
B- Myxedema:
This is the condition of hypothyroidism
in adults.
It is characterized by:
(1) Low metabolic rate and reduced
heat production, with increased feeling
of
(2)cold.
Body weight is increased, with
accumulation of mucoproteins under
the skin, giving edematous
appearance that is most evident in
(3)
the face.Increased blood lipids,
particularly cholesterol, leading to
atherosclerosis.
(4) Slow heart rate.
(5) Depressed reproductive
functions.
 II- Hyperthyroidism (thyrotoxicosis):
Toxic joiter:
It is mostly result from the development of thyroid
tumor.
Symptoms:
(1) Increased metabolic rate with increased feeling of
warmth.
(2) Increased sweating (due to increased heat loss).
(3) Body weight loss and muscular weakness.
(4) Hyperglycemia and decreased blood lipids.
(5) Increased cardiac output, excitability and
nervousness.
 II- Hyperthyroidism (thyrotoxicosis):
Grave’s disease:
Is a condition in which toxic goiter is associated with
exophthalmos (eye ball protrusion).

The cause of protruding eyes is

a hormonal substance called
exophthalmos-producing
substance, which is secreted by
the anterior pituitary in some
hyperthyroid patients (about
30%) instead of TSH.
 II- Hyperthyroidism (thyrotoxicosis):
Simple Goiter:
It is caused in response to deficiency in dietary iodine.
So, the lack of iodine leads to
lowered thyroid hormones and
raised TSH, which stimulates thyroid
gland to secrete large amounts of
thyroglobulin, but increased thyroid
hormones production does not
occur, (due to iodine lack).
Therefore, the follicles become
enlarged in size with normal
activity.
Simple goiter may be due to the
increased thyroid hormone
requirement at puberty or during
pregnancy or lactation.