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Thyroid Hormones

Thyroid gland is located just below the larynx. Thyroid is the largest of the pure endocrine glands. Follicular cells secrete thyroxine. Parafollicular cells secrete calcitonin.

Thyroid gland : the thyroid gland ,located immediately below the larynx on each side of and anterior to trachea ,consist of two lobes connected by isthmus The thyroid secretes two major hormones ,thyroxin(T4) or tetraiodthyronin and triiodothyronin(T3) these concerned with metabolism .the thyroid gland also secretes calcitonin, an impotant hormone for calcium metabolism . Thyroid gland has got a characteristic feature in trapping iodide from the circulation.this feature is also present in salivary gland,intestinal mucosa ,mammary gland,ciliary body and choroid plexuses ,but cannot synthesize thyroid hormone

Formation of thyroid hormone

1,iodide pump(iodide trapping) ,the first stage in the formation of thyroid hormones is transport of iodides from the blood into thyroid glandular cells and follicles .the basel membrane of the thyroid cell has the specific ability to pump the iodide actively to the interior of the cell this is called iodide trapping .

The rate of iodide trapping by the thyroid is influenced by the concentration of TSH which stimulates the pump 2, oxidation of the iodide ion. Is conversion of the iodide ions to an oxidized form of iodine ,this oxidation of iodine is promoted by the enzyme peroxidase 3, iodination of tyrosine and formation of the thyroid hormones Oxidized iodine will be secreted to the lumen of follicle where it will bind directly but very slowly with the amino acid tyrosine .tyrosine is first ionized to monoiodotyrosine and then to diiodotyrosine .2molecules of diiodotyrosine will be form thyroxin(T4) and one monoiodotyrosine with one diiodotyrosine will form triiodothyronin(T3) All these forms will attach to a protein called thyroglobulin, which is a glycoprotein .itis synthesized in the thyroid cells and secreted by the thyroid cells into the colloid in lumen of the follicle under the effect of TSH .the thyroid hormones remain part of the thyroglobin molecules until secreted When needed thyroxin and triiodothyronine must first be cleaved from the thyroglobulin molecule ,and then these free hormones are released on entering the blood ,over 99% of the thyroxine and triiodothyronine combines immediately with several of the plasma proteins , all of which are synthesized by the liver .they combine mainly with thyroxin binding globulin (TBG)binds mainly to T4,and much less so with thyroxine-binding prealbumin(TBPA)bound mainly to T3 and albumin Thyroxine(T4) are released to the tissue cells slowely ,has high affinity for binding with blood proteins. While triiodothyronine because of it,s lower affinity to binding with blood proteins is released to the cells easier Physiological action of thyroid hormone : 1.thyroid hormones increase the transcription of large numbers of genes

2, thyroid hormones increase cellular metabolic activity . the thyroid hormone increase the metabolic activities of almost all the tissues of the body.there will be increase the number and activity of mitochondria which increase the rate of formation of ATP 3, has calorigenic action T3and T4 increase the O2 consumption and heat production of almost all metabolically active tissues the exception are the adult brain ,testes,uterus,lymph nodes, spleen,and anterior pituitary 4,effect on carbohydrates,fat and protein Carbohydrates: it stimulate rapid intake of glucose by the cells ,enhanced glcolysis ,enhanced hepatic gluconeogenesis, increase rate of absorption from GIT,and even increased insulin secretion,so we have increase in blood glucose concentration Fat :it has lipolytic action.lipids are mobilized rapidly from the fat tissue which decreases the fat stores of the body, this also increases the free fatty acid concentration in the plasma,it also decrease the concentration of cholesterol, phospholipids, and triglyceride in plasma protein: it stimulate the synthesis of specific proteins ,but if we have increase in the level of thyroid hormone it cause protein break down especially in the muscles and cause muscle weakness Vitamins thyroid hormone cause increase need for vitamins 5,effect of thyroid hormone on the cardiovascular system .it increase blood flow and cardiac output,the increase metabolism cause vasodilation in most body tissues thus increasing blood flow,the rate of blood flow in the skin especially increases because of the increase need for heat elimination from the body 6.effect on respiration :the increase rate of metabolism increase the utilization of O2 and formation of CO2 these effects activate all the mechanisms that increase the rate and depth of respiration to get rid of the accumulated CO2

7,effect on GIT :thyroid hormone cause the increase in the absorption of food stuffs and an increase in the rate of secretion of digestive juice and increase in the motility of GIT 8,effect on growth(effect on the bone):thyroid hormones are essential for normal growth and skeletal maturation and thyroid hormone potentiate the effect of growth hormone on the tissues 9, effect on central nervous system thyroid hormone promote growth and development of the brain 10. effect on sextual function ,in men lack of thyroid hormone is likely to cause loss of libido ,great excess of hormone ,however sometime cause impotence In women ,lack of thyroid hormone often causes menorrhagia and polymenorrhea ,while in hyperthyroid women oligomenorrhea and occasionally amenorrhea occur 11. effect on other endocrine glands ,increase thyroid hormone increase the rates of secretion of most other endocrine glands ,but it also increases the need of tissues for the hormone ,thyroid hormone increase rate of glucocorticoid secretion by adrenal glands

Clinical conditions
Enlargement of the thyroid gland for any reason is called goiter .the metabolic function of the gland is either increase or decrease (hyper or hypothyroidism) Endemic goiter Usually in places where iodine is insufficient in food ,so there is inadequate formation of the thyroid hormone .the mechanism for development of large endemic goiters is the following :lack of iodine prevents production of TSH by the anterior pituitary this causes the pituitary to secrete excessively large quantities of TSH. The TSH then stimulates the thyroid cells to secrete tremendous amounts of thyroglobulin colloid into the follicles .and the gland grows larger and

larger.but because of lack of iodine ,thyroxine and triiodothyronine production does not occur in the thyroglobulin molecule and therefore does not cause the normal suppression of TSH production by the anterior pituitary

Iodopathic nontoxic colloid goiter

Enlarged thyroid glands similar to those of endemic colloid goiter can also occur in people who do not have iodine deficiency .these goiterous glands may secrets normal quantities of thyroid hormone but more frequently the secretion of hormone is depressed, as in endemic colloid goiter.the exact cause of the enlarged thyroid gland in patients with iodiopathic colloid goiter is not known,but most of these patient show signs of mild thyroiditis Hypothyroidism The cause is either in the thyroid gland or in pituitary or hypothalamus so the cause of hypothyroidism :thyroiditis,endemic colloid goiter, idiopathic colloid goiter, destruction of the thyroid gland by irradiation,or surgical removal of the thyroid gland Physiological characteristics of hypothyroidism Fatigue ,and extreme somnolence ,extreme muscular sluggishness,,slowed heart rate, decrease cardiac out put , decreased blood volume ,some time increase body weight ,constipation,mental sluggishness,depress growth of hair ,dryness of the skin and hair,development of an edematous appearance throughout the body called myxedema, lack of thyroid hormone increases the quantity of blood cholesterol ,the increase in blood cholesterol is usually associated with increased atherosclerosis Cretinism ,it is caused by extreme hypothyroidism during fetal life, infancy, or childhood ,this condition is characterized especially by failure of the body growth and by mental retardation Hyperthyroidism

Excessive thyroid secretion ,in hyperthyroidism the level of TSH is reduced .but it is not accompanied by the decrease in thyroid hormone because there are substances which have similar action to that of TSH found in blood of almost all patients ,these are immunoglobulin antibodies that bind with the same membrane receptors that bind TSH ,they induced continual activation of the cAMP system of the cells with resultant development of hyperthyroidism .these antibodies are called thyroid stimulating immunoglobulin (TSI) Hyperthyroidism occasionally results from a localized adenoma (a tumor) that develops in the thyroid tissue and secrets large quantities of thyroid hormone Symptoms of hyperthyroidism High state of excitability, intolerance to heat, increase sweating, mild to extreme weigh loss, increase apetite ,muscle weakness, tremor of the hand ,vitamin deficiency especially D. extreme fatigue but inability to sleep, varying degree of diarrhea ,nervousness and other psychic disorder ,exophthalmos (protrusion of eye balls ) Calcitonin :this peptide hormone is synthesized and secreted by the parafollicular cells (c-cells) it is also called calcium lowering hormone it is not under control of pituitary or hypothalamus control ,it is affected by level of calcium in blood when it increases it stimulate the hormone mobilizes the calcium from the blood to the bone and enhance osteoblastic activity so it is opposes the parathyroid hormone We have increase init is level when there is need to calcium ,growth ,pregnancy ,and lactation.