THYROID GLAND

Largest of endocrine glands weighs 15-20 gs! In ad"lts

Located iediatel# $elow the lar#n% & on each side ' anterior
to trachea!
(ecretes two i)ortant horones Th#ro%in *T+, '
Triiodoth#ronine *T-,
.oth of these increases the ./R of the $od#! Their secretion is
controlled $# TH( froanterior )it"itar# gland
Th#roid gland also s#nthesi0e 1alcitonin *for calci"
eta$olis!
TRH *H#)othala"s,
T(H *Anterior 2it"itar# gland,
THYROID GLAND
T- ' T+
SYNTHESIS & SECRETION OF THYROID METABOLIC
HORMONES
Th#roid gland secretes 3-4 *T+, ' 54 *T-,!
At the le6el of tiss"e all the T+ e6ent"all# con6erted into T-!
T- is ore )otent as co)ared to T+! $"t its concentration is 6
low ' )ersist for a shorter d"ration as co)ared to T+!
Physiologic anatomy of thyroid gland.
1o)osed of large n"$er of follicles ' filled with a
s"$stance called colloid!
Lined $# c"$oidal e)itheli"!
/a7or constit"ent of colloid is a gl#co)rotein called
th#roglo$"lin & contains th#roid horone within its olec"le!
The gland has a rich $lood s"))l#!
Role of Iodine for thyroid hormone synthesis
Iodine is re8"ired for horonal s#nthesis
Noral re8"ireent is 1g9wee: or 50 g9#ear!
1oon salt is iodi0ed with sodi" iodide
Fate of ingested iodide.
Iodide ingested orall# are a$sor$ed fro GIT into the $lood!
Iodide is trans)orted fro $lood into the th#roid gland"lar
cells ' follicles!
.asal e$rane acti6el# )")s the iodide to the interior of
the cell *iodide Tra))ing,!
T(H increases the iodide tra))ing
The ;R ' Golgi a))arat"s of follicle secretes a gl#co)rotein
*Th#roglo$"lin,!
The Gl#co)rotein contains aino acid T#rosine that
co$ines with Iodine to forth#roid horones!
(T;2( O< (YNTH;(I(
1, Iodide is o%idi0ed to iodine *$eca"se o%idi0ed for is
ca)a$le to co$ine with AA T#rosine,
2, O%idation is )rooted $# H#drogen )ero%ide ' 2ero%idase
en0#e located on the a)ical e$rane of the cell!
-, Iodine co$ines with T#rosine *iodinase,to for/IT
Iodinase
Iodine = T#rosone /onoiodot#rosine*/IT,
/IT = /IT Diiodot#rosine *DIT,
/IT = DIT Triodoth#ronine *T-,
DIT = DIT Thro%ine *T+,
After its foration it is stored in the th#roglo$"lin of th#roid
follicle!
This ao"nt is s"fficient for re8"ireent of 2-- onths
Release of T3 & T4 from gland.
T- ' T+ is clea6ed fro th#roglo$"lin ' than released into the
$lood $# the following )rocess>
1, The a)ical s"rface of the th#roid cell sends o"t )se"do)ods
that encircles sall )ortion of colloid to for )inoc#tic
6esicle that enters into the a)e% of th#roid cell!
2, The l#sosoes releases digesti6e en0#es *)roteinases,
clea6ing th#roglo$"lin olec"les ' releases T- ' T+ which
"ltiatel# releases into the $lood!
(oe of the iodinated t#rosine reains in /IT ' DIT for
which after release fro th#roglo$"lin do not release into the
$lood!
."t clea6ed $# deiodinase en0#e that rec#cle iodine for the
ne%t s#nthesis of T- ' T+
1ongenital deficienc# of this en0#e *deiodinase, a:e a
)erson iodine deficient $eca"se of fail"re of rec#cling )rocess!
T+ is 3-4 '
T- is 54 & $"t t+ is "ltiatel# con6erts into T- at the tiss"e
lle6el
Transport of T3 & T4 to the tissue
In the $lood 334 of T- ' T+ co$ines with )lasa )roteins
th#ro%in $inding glo$"lin ' to a lesser e%tent with th#ro%in
$inding al$"in )re-al$"in ' al$"in!
Functions of T3 & T4.
1, Increase in gene transcri)tion>
Th#roid rece)tors are )resent on DNA strand where it
ca"ses transcri)tion ca"ses foration of RNA !
1a"ses RNA translation $# ca"sing )rotein s#nthesis!
2) Increase in cellular metabolic activity.
./R can increase ") to ?0-1004a$o6e the noral!
@tili0ation of food for energ# is a"gented!
Increase )rotein ana$olis' cata$olis
Increases the>
growth of a )erson&
ental acti6it#&
(i0e ' no! of itochondria! Leading to increase in AT2
s#nthesis '
Na9A AT2ase en0#e
3)Effect on CHO metabolism
Th#roid horones increases>
i, Gl"cose ")ta:e $# the cell
ii, Gl#col#sis
iii, Gl"coneogenesis
i6, Rate of a$sor)tion fro GIT
6, Ins"lin secretion!
4) Effect on Fat metabolism
Increases fat o$ili0ation fro tiss"e leads to decrease in
fat content of the $od#
This leads to increase in <A o%idation ' fatt# acid
concentration in )lasa
Increase Th#roid horone secretion decreases concentration
of cholesterol& TGs ' )hos)holi)ids in )lasa!
/;1HANI(/>
It increases LDL rece)tors in Li6er cells& leading to ra)id
reo6al of LDL fro )lasa $# li6er ' s"$se8"ent secretion of
cholesterol in these li)o)roteins $# li6er cells!
5) Effect on CVS:
i) effect on Heart rate & Heart strength:
It has $oth ionotro)ic ' chrotronotro)ic *H!R!, effect!
Ionotro)ic effect is d"e to increase no of B adrenergic rece)tors!
1hronotro)ic effect is d"e to circ"lating le6els of
catecholaines!

ii) effect on blood flow & cardiac out put:

Increase eta$olis ca"se foration of eta$olic wate
)rod"cts that ca"ses 6asodilatation ' increase $lood flow!
.lood flowcan soetie increase to ?0-1004a$o6e noral!
6) Effect on Respiration:
Increases rate ' de)th of res)iration& d"e to increase in O2
"tili0ation ' foration of 1O2!
7) Effect on GIT:
Increases a))etite ' food inta:e!
Also increases the secretion of digesti6e 7"ice ' intestinal
otilit# leading to dirrohea!
8) Effect on CNS:
Increases 1N( e%cita$ilit#!
In h#)erth#roidis there is e%tree ner6o"sness ' an%iet# d"e
which slee) is also dist"r$ed!
9) Sympthetomimetic effect;
Increases target cell res)onsi6eness to catecholaines
Th"s increase th#roid horone le6el )rod"ces effect siilar to
that of acti6ated ner6o"s s#ste&
1) Effect on muscle:
1a"ses "scle to react with ore 6igor!
;%cess ca"ses "scle to $ecoes wea: d"e to increased
)rotein cata$olis
In its deficienc# there is wea:ness & cra)s ' stiffness!
1) Effect on other endocrine glands.
Causes increase:
Ins"lin *d"e to increase gl"cose eta$olis,&
2TH '
Gl"cocorticoid release
;<<;1T ON GROCTH>
;ssential for noral growth ' at"ration!
In h#)oth#roid childrenDs& $one growth is slowed ' e)i)h#sial
clos"re is dela#ed!
Growth horone secretion is also de)ressed th"s f"rther
i)airs growth ' de6elo)ent!
Reg"lation of Th#roid Horones
stress*-, *=,cold in infants
HY2OTHALA/@(
TRH
Do)aine& soat! Gl"c *-,
ANT;RIOR 2IT@ITARY*-,
T(H
THYROID GLAND
T-' T+ */eta$olic ;ffects,
PATHOPHYSIOLOGY
1) HYPERTHYROIDISM:
CA!SES:
Thyroid Overactivity:
Gra6eEs Disease *d"e to T(I,
To%ic adenoa
Th#roiditis
T(H secreting 2it"itar# t"ors
E"tra Thyroidal causes
Adinistration of T- ' T+!
;cto)ic Th#roid Tiss"e
(igns of H#)erth#roidis>
Tach#cardia *inc! H!R!,
Hot oist )als
Goiter
<ine treors *o$ser6ed $# )lacing )a)er o6er the e%tended
fingers ' noting the degree of 6i$ration of the )a)er
;%o)hthalos *lid lag9lid retraaction,
.r"it
Symptoms:
;%cita$ilit#!
Intolerance to heat!
(weating
Ceight loss!
Diarrhea
/"scle wea:ness
;%cess a))etite
2al)itation '
tiredness
LA.! <INDING(
<ree T- ' T+ le6el are raised!
T(H decreased
T(I are )resent
./R is increased !
2) HYPOTHYROIDISM
Decreased secretion of th#roid horones d"e to>
1, disease of th#roid gland
2, h#)othalaic fail"re *h#)othalaic h#)oth#roidis,
-, 2it"itar# fail"re *2it"itar# H#)oth#roidis,
1, DI(;A(; O< THYROID GLAND
D"e to>
a, A"toi"nit# that destro#s the th#roid gland *Th#roiditis,
$, Genetic defect in th#roid gland
2, ;ND;/I1 1OLLOID GOIT;R
Goiter is the enlargeent of th#roid gland!
Lac: of iodine in diet )re6ents T- ' T+ foration!
1a"ses increase )rod"ction of T(H $# anterior )it"itar# gland
ca"sing increased )rod"ction of th#roglo$"lin leading to goiter!
-, idio)athic non-to%ic colloid goiter>
1a"se is "n:nown!
2ts! Has th#roiditis with res"ltant increase T(H )rod"ction
leading to goiter
(IGN( O< HY2OTHYROIDI(/
.rad#cardia
1old e%treities
Dr# hair ' s:in
2erior$ital )"ffines
Hoarse 6oice
.rad#:inesis F slow o6eent
Dela#ed 7er:s
(Y/2TO/( O< HY2OTHYROIDI(/
Tiredness
/ental letharg#
1old intolrence
Ceight gain
1onsti)ation
/enstr"al dist"r$ances
1ar)el t"nnel s#ndroe
DIAGNO(TI1 1RIT;RIA
HY2OTHYROIDI(/
1, <ail"re of Th#roid> T-&T+ & T(H
2, secondar# to H#)othalic ' 2it"itar# fail"re>
T-& T+& TRH ' T(H *all are ,
-, Lac: of Iodine >
T-&T+ ' T(H !
HY2;RTHYROIDI(/
1, Gra6esE disease> T-&T+ T(H
2, (econdar# to h#)othala"s or 2it"itar# gland>
T-& T+ & T(H ' TRH *all are increased,
-, Th#roid t"or> T-& T+ & T(H !