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Follicles and Colloid – Follicular Epithelial Cells –Colloidstores thyroid hormone Follicles and Colloid Thyroglobulin • IodineIodine-containing; made from tyrosine • Tetraiodothyronine = T4 =Thyroxine • Triiodothyronine = T3 • Reverse T3 = rT3 = an isomer Parafollicular Cells(C cells) • Calcitonin • 1) Synthesis of Thyroglobulin – Follicular epithelial cells – Tyrosine – Secreted into the Colloid • 2) Iodide Trapping – Plasma into Epithelial Cells – Thiocyanates can block 1 h • 3) Oxidation of Iodide – Thyroid peroxidase • 4) Organification – MIT(monoiodothyronine) – DIT(diiodothyronine) • oxidizes Iodide to form Iodine TPO I¯ Ð I – Thiouracils can block • DIT + MIT = T3(10%) rT3 (<1%) • DIT + DIT = T4(90%) Secretion of Thyroid Hormones • 5) STORAGE Thryoglobulin • T4 and T3 released from cell into plasma • Tyrosine and I are recycled • Thyroxine binding globulin (75% T-4; 75% T-3) • Thyroxine binding prealbumin (15% T-4; 0% T-3) • Thyroxine binding albumin * (10% T-4; 25% T-3) * Starvation inhibits this enzyme 2 Thyroid Stimulating Hormone • • • • Enhances Iodide trapping Enhances synthesis of T4 and T3 Enhances the endocytosis of the colloid Enhances the proteolysis of the thyroglobulin • Enhances the release of T4 and T3 • Metabolic Actions • Sympathomimetic Effect • Reproduction • Symptoms (Infants and Children) – – – – – R.D.S. Retarded Bone Age Mental Retardation Stunted Growth Delayed or absent sexual maturity • Maturational/Differentiational • Neurological Effects • Growth Hypothyroidism • Primary - failure of gland itself • Secondary - TRH or TSH related deficiency • Nutritional • Symptoms (Adults) – – – – – – Low BMR Poor resistance to cold Weight gain Slow thinking Thin and brittle hair Weakness, fatigue, lethargy – MYXEDEMA 3 Hypothyroidism Treatment – THYROXINE PREPARATIONS Hyperthyroidism (Thyrotoxicosis) • Graves’ Disease • Symptoms – – – – Increased BMR Heat Intolerance Increased appetite Elevated HR and arrhythmias, – Nervous, irritable – Exopthalmus • LEVOXYL • SYNTHROID Hyperthyroidism • Treatment – Surgery – 131I – Thiouracils – (PROPACIL) Goiter • Enlarged Thyroid Gland • Hyperthyroidism or Hypothyroidism • Iodide deficiency 4