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Thyroxine, also known as T 4, is a hormone produced by the thyroid gland.It is the primary form of thyroid hormone found in the blood and acts as a prohormone of the more active thyroid hormone, triiodothyronine (T 3). [1]
Levothyroxine, also known as L-thyroxine, is a synthetic form of the thyroid hormone thyroxine (T 4). [5] [8] It is used to treat thyroid hormone deficiency (hypothyroidism), including a severe form known as myxedema coma. [5]
The sum activity of peripheral deiodinases (G D, also referred to as deiodination capacity, total deiodinase activity or, if calculated from levels of thyroid hormones, as SPINA-GD [a]) is the maximum amount of triiodothyronine produced per time-unit under conditions of substrate saturation. [1]
Euthyroid sick syndrome (ESS) is a state of adaptation or dysregulation of thyrotropic feedback control [1] wherein the levels of T3 and/or T4 are abnormal, but the thyroid gland does not appear to be dysfunctional.
Thyroid hormones act on nearly every cell in the body. They act to increase the basal metabolic rate, affect protein synthesis, help regulate long bone growth (synergy with growth hormone) and neural maturation, and increase the body's sensitivity to catecholamines (such as adrenaline) by permissiveness. [12]
Blood free thyroxine and TSH levels are monitored to help determine whether the dose is adequate. This is done 4–8 weeks after the start of treatment or a change in levothyroxine dose. Once the adequate replacement dose has been established, the tests can be repeated after 6 and then 12 months, unless there is a change in symptoms. [8]
In starvation or severe somatic stress, deiodinase type 1 is inhibited which lowers circulating levels of T 3 (due to it being the main source of peripherally converted T 3 from T 4 in the plasma), causing a decrease in the metabolic rate. [3]
Congenital iodine deficiency syndrome (CIDS), also called cretinism, [2] is a medical condition present at birth marked by impaired physical and mental development, due to insufficient thyroid hormone production (hypothyroidism) often caused by insufficient dietary iodine during pregnancy.
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