The complex, rate-limiting physiological process by which the relatively inactive prohormone Thyroxine (T4) is converted into the biologically active thyroid hormone Triiodothyronine (T3) within peripheral tissues, primarily the liver and kidneys. Optimal conversion dynamics are essential for maintaining a healthy metabolic rate, energy production, and mood regulation. Impairment in this process is a common cause of hypothyroid symptoms despite normal TSH and T4 levels.
Origin
This term is rooted in thyroid endocrinology, specifically the study of deiodinase enzymes (D1, D2, D3) that catalyze the removal of iodine atoms from T4. ‘Dynamics’ emphasizes the highly variable and context-dependent nature of this conversion, which is influenced by nutritional status, inflammation, and cortisol levels.
Mechanism
The conversion mechanism is catalyzed by deiodinase enzymes, with D1 and D2 converting T4 to T3, and D3 converting T4 to the inactive Reverse T3 (rT3). The dynamic involves the balance of these enzymatic activities, which is critically dependent on cofactors like selenium and zinc. Clinical intervention often focuses on optimizing these cofactors and mitigating inflammatory signals that shunt conversion toward the inactive rT3 pathway.
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