Synthesis of thyroxine
Iodide is transported along with Na+ using secondary active
transport into the basolateral membrane of the follicle cell, Na+ is
then pumped back using Na+/K+ ATPase pumps. This process is
known as iodide trapping, then using transport proteins called
pendrins iodide is transported into the colloid across apical
membrane where it is oxidised to iodine and attached to phenolic
rings of tyrosine in thyroglobulin. This reaction is catalysed by the
enzyme thyroid peroxidase.
When the tyrosine is attached to one iodine, it is known as
monoiodotyrosine and when it is attached to two it is known as
diiodotyrosine, next the phenolic ring of MIT or DIT is removed and
then coupled to another DIT, forming T3 or T4 respectively.
T4 is converted into T4 in the cells for hormone action.
Thyroid hormone function
T3 exerts general control over basal metabolic rate (BMR), has
several carbohydrate and lipid metabolism.
It also stimulates ATP production which is used for maintaining
Na+/K+ ATP pumps. ATP production leads to heat production
therefore thyroxine is also used for thermoregulation in cold
regions.
Hypothyroidism and Hyperthyroidism
Hypothyroidism can be caused due to loss in functionality of thyroid
gland, this can lead to low thyroxine hormone concentration in the
plasma, high TSH concentration in plasma and high TRH
concentration in portal circulation.This can lead to hypertrophy of
thyroid gland and later goitre. This can be correct by the intake of
more iodine in the diet
Another cause of hypothyroidism is autoimmune thyroiditis where
the immune system is disrupted, one common form of this is
Hashimoto’s disease. It is marked by damage to the thyroid gland
due to attack by lymphocytes. This is also marked by goitre as TSH
concentration is high in blood and thyroxine does not exert negative
feedback on adenohypophysis.
Hypothyroidism can also be caused due to loss in functionality of
adenohypophysis, this is marked by low release of TSH and
subsequent atrophy of the thyroid gland.
Hypothyroidism results in cold intolerance due to the low calorigenic
effect of low plasma thyroxine levels and a tendency to weight gain.
It also results in puffiness of the face due to overexpression of
hydrophilic compounds known glycosaminoglycans which trap
water in their proximity. This characteristic is known as myxedema.
Hyperthyroidism or thyrotoxicosis can be caused by tumour cells
which secrete abnormal amounts of thyroxine, although this is very
rare. Commonly hyperthyroidism is caused by overstimulation of the
thyroid gland due to activation of TSH receptors on the thyroid
follicle membranes by antibodies(Graves’ disease). This also leads
to high hypertrophy of thyroid gland, hyperthyroidism results in
increased appetite, reduced weight, anxiety and increased activity
of sympathetic nervous system and adrenaline as thyroxine
stimulates the activity of beta adrenergic receptors.
