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Industrially, levothyroxine is made by chemical synthesis. Tyrosine is a common starting material. [36] The produced hormone is incorporated into drugs as its sodium salt, levothyroxine sodium. Solid drugs such as tablets contain the pentahydrate form of the salt. [37]
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]
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 ]
The follicular lumen is filled with colloid, a concentrated solution of thyroglobulin and is the site of synthesis of the thyroid hormones thyroxine (T4) and triiodothyronine (T3). [16] Parafollicular cells. Scattered among follicular cells and in spaces between the spherical follicles are another type of thyroid cell, parafollicular cells. [4]
Thyroid peroxidase oxidizes iodide ions to form iodine atoms for addition onto tyrosine residues on thyroglobulin for the production of thyroxine (T 4) or triiodothyronine (T 3), the thyroid hormones. [1] In humans, thyroperoxidase is encoded by the TPO gene. [2]
The compound migrated close to thyroxine in chromatography and they initially named it 'unknown 1' . Around that time a group led by Jean Roche in Paris described a deiodinating activity in the sheep thyroid gland, raising the possibility that 'unknown 1' is the less iodinated analogue of T4, triiodothyronine. [ 24 ]
Reverse T 3 is the third-most common iodothyronine the thyroid gland releases into the bloodstream, at 0.9%; tetraiodothyronine (levothyroxine, T 4) constitutes 90% and T 3 is 9%. However, 95% of rT 3 in human blood is made elsewhere in the body, as enzymes remove a particular iodine atom from T 4. [1]
Levothyroxine is a stereoisomer of thyroxine (T4) which is degraded much more slowly and can be administered once daily in patients with hypothyroidism. [13] Natural thyroid hormone from pigs is sometimes also used, especially for people who cannot tolerate the synthetic version.