How is thyroid hormone synthesized and released?
·
Step 1: Iodine, essential for thyroid-hormone synthesis, is reduced to iodide in the stomach
and absorbed into the bloodstream by the gastrointestinal tract. Iodide is then
absorbed by thyroid follicular cells, which “trap” and concentrate it. Inhibitors of iodide absorption are:
circulating iodide, thiocyanate, and perchlorate.
·
Step 2: Iodide combines with tyrosine residues on thyro-globulin to form
monoiodotyrosine (MIT) and then diiodotyrosine (DIT). Iodinated tyrosines join
to create T3 (MIT + DIT) and T4 (DIT + DIT) and bind to
thyro-globulin. Inhibitors of T3
and T4 synthesis are: propyl-thiouracil (PTU)
and methimazole.
·
Step 3: T3 and T4 are cleaved from thyroglobulin and secreted into the circulation. T4
comprises 95% of released hormone. Approximately one third of secreted T4
is converted to T3 in the kidney and liver. Inhibitor of conversion of T4
to T3 is: PTU but not methimazole.
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