The comprehensive oversight and regulation exerted by the Hypothalamic-Pituitary-Thyroid (HPT) axis over the body’s basal metabolic rate, thermogenesis, and overall energetic setpoint. Command refers to the central control over the synthesis, release, and peripheral conversion of thyroid hormones (T4 and T3). This axis dictates the speed of cellular activity throughout the body.
Origin
This terminology is a functional description of the HPT axis, emphasizing its role as the master regulator of basal metabolism. “Command” signifies the hierarchical nature of its control over virtually all other physiological processes dependent on energy turnover.
Mechanism
The mechanism begins with the hypothalamus releasing TRH, stimulating the pituitary to secrete TSH, which then signals the thyroid gland to produce T4 and T3. Peripheral tissues possess deiodinases that convert the relatively inert T4 into the active T3, which binds to nuclear receptors to modulate gene transcription related to mitochondrial function and protein synthesis. Clinical command involves ensuring TSH drives appropriate T4 release and that peripheral conversion to T3 is efficient.
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