Thyroid conversion is the critical metabolic process where the prohormone thyroxine (T4), secreted by the thyroid gland, is enzymatically deiodinated in peripheral tissues, primarily the liver and kidneys, to form the biologically active hormone triiodothyronine (T3). This conversion step is rate-limiting for thyroid hormone action, as T3 is the molecule that binds to nuclear receptors to regulate gene expression and metabolic rate. The efficiency of this conversion is vital for systemic energy homeostasis.
Origin
The concept emerged from the discovery that T4, while the major secretory product, was largely a storage form, and T3 was the actual functional hormone. The term describes the biochemical transformation necessary for the hormone to exert its effects. Understanding this peripheral conversion has been crucial for managing thyroid disorders that involve impaired T4-to-T3 metabolism.
Mechanism
The conversion is catalyzed by a family of enzymes called deiodinases (D1, D2, and D3), which remove an iodine atom from the outer ring of T4 to produce T3. Factors like nutrient status, inflammation, and stress hormones like cortisol can significantly modulate the activity of these deiodinases, thereby altering the final T3 concentration available to target tissues. Clinical assessment must therefore consider both T4 levels and the efficiency of this peripheral conversion.
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