EMRGI LECTURE 5: ENDOCRINE

DEFINITION HORMONE STRUCTURES & SYNTHESIS

● The endocrine system consists of all the glands, termed ● Hormones fall into 3 chemical classes, dictate on how they will
endocrine glands that secrete hormones act upon
○ Known as ductless glands to accommodate & transported ○ Proteins & polypeptides - great majority of hormones
to target cells ■ Examples are hormones secreted by:
● Known as the Secondary control system of the body ● Anterior & posterior pituitary gland
○ Slow acting control system by using hormones ● Pancreas (Insulin & glucagon)
● Glands - secretory organs ● Parathyroid gland (Parathyroid hormone)
● Examples: ● And many others
○ Hypothalamus ■ Water soluble
○ Pituitary gland - master gland ● Allowing them to enter the circulatory
○ Pineal gland - responsible for sleep-wake cycle system easily, where they are carried to
○ Parathyroid gland - control of calcium levels their target tissues much more efficiently
○ Thyroid gland - control of calcium levels ○ Steroids - similar chemical structure to cholesterol
○ Thymus gland - large in small children; decreases with age ■ Usually synthesized from cholesterol and are not
○ Adrenal glands - fight or flight hormones stored
○ Pancreas - insulin/glucagon for blood levels ■ Lipid soluble, difficult to transfer in bloodstream
○ Ovaries/Testes - secondary sex characteristics & ■ Once synthesized, simply diffuse across cell
reporductive functioning membrane & enter interstitial fluid & then blood
● Hormones - chemical messengers that enter the blood which ■ Examples:
carries them from the endocrine glands to the cells upon which ● Adrenal cortex
they act (target cells) ● Gonads (Testes & Ovaries)
○ Cells influenced by a particular hormone are the target ● Placenta during pregnancy
cells for that hormone ○ Amines - derivatives of amino acid tyrosine
● Chemical Messengers: ■ Examples:
○ Neurotransmitters - found in Nervous system (GABA) ● Thyroid hormones
○ Endocrine hormones - endocrine glands ● Epinephrine & norepinephrine (Adrenal
○ Neuroendocrine hormones - influence the function of the Medulla)
Nervous system ● Dopamine (Hypothalamus)
○ Paracrine - affect neighboring target cells
○ Autocrine - self-activating hormone; affect function of the
HORMONE SECRETION, TRANSPORT & CLEARANCE
same cells that produced them
○ Cytokines - responsible for activation of immune cells or Onset of Hormone Secretion After Stimulus, & Duration of Action
any cells it may attract of Different Hormones

○ Some hormones (e.g. norepinephrine & epinephrine) are secrets

within seconds after the gland is stimulated
○ May develop full action within another few seconds to minutes

○ Actions of other hormones (like thyroxine or growth hormones )

may require months for full effect
○ Concentration of hormones required to control most metabolic &
endocrine functions are incredibly small
■ Ranges from as little as 1 pg (1 millionth of 1 millionth of a
gram) in each mL of blood up to at most a few µg (a few
millionths of a gram) per mL of blood
○ Rates of secretion of the various hormones are extremely small,
usually measured in µg or mg per day

Feedback Control of Hormone Secretion

● Negative feedback prevents overactivity of hormone systems

○ After a stimulus causes release of the hormone
■ Conditions or products resulting from the action of
the hormone tend to suppress its further release
● Surges of hormones can occur with positive feedback
○ Occurs when the biological action of the hormone causes
additional secretion of the hormone
■ Example: surge of luteinizing hormone (LH) before
ovulation
● Secreted LH then acts on ovaries to
stimulate additional secretion of estrogen
which in turn causes more secretion of LH
● Cyclical variations occur in hormone release
○ Periodic variations in hormone release that are influenced
by seasonal changes, various stages of development &
aging, the diurnal (daily) cycle, & sleep
 ■ E.g. secretion of growth hormone is markedly ■ Temporary sequestration of the receptor to the
increased during the early period of sleep but is inside of the cell, away from the site of action of
reduced during the later stages of sleep hormones that interact with cell membrane
receptors
■ Destruction of receptors by lysosomes after being
Transport of Hormones in the Blood
internalized
■ Decreased production of the receptors
● Water-soluble hormones (peptides & catecholamines)
○ In each case, receptor down-regulation decreases the
○ Dissolved in the plasma & transported from their sites of
target tissue’s responsiveness to the hormone
synthesis to target tissues
● Up-regulation of receptors and intracellular signaling proteins
■ Diffuse out of the capillaries, into the interstitial
○ The stimulating hormone induces greater than normal
fluid, & ultimately to target cells
formation of receptor or intracellular signaling molecules
● Steroid & thyroid hormones - circulate in the blood mainly bound
by the protein-manufacturing machinery of the target cell
to plasma proteins
○ Or greater availability of the receptor for interaction with
○ Protein-bound hormones can’t easily diffuse across the
the hormone
capillaries & gain access to their target cells
○ When this occurs, the target tissue becomes progressively
■ Are biological inactive until they dissociate from
more sensitive to the stimulating effects of the hormone
plasma proteins

Intracellular Signaling After Hormone Receptor Activation

Clearance of Hormones from Blood

● Hormone affects its target tissues by first forming a

𝑅𝑎𝑡𝑒 𝑜𝑓 𝑑𝑖𝑠𝑎𝑝𝑝𝑒𝑎𝑟𝑎𝑛𝑐𝑒 𝑜𝑓 ℎ𝑜𝑟𝑚𝑜𝑛𝑒 𝑓𝑟𝑜𝑚 𝑝𝑙𝑎𝑠𝑚𝑎
𝑀𝑒𝑡𝑎𝑏𝑜𝑙𝑖𝑐 𝐶𝑙𝑒𝑎𝑟𝑎𝑛𝑐𝑒 𝑅𝑎𝑡𝑒 = 𝐶𝑜𝑛𝑐𝑒𝑛𝑡𝑟𝑎𝑡𝑖𝑜𝑛 𝑜𝑓 ℎ𝑜𝑟𝑚𝑜𝑛𝑒 𝑖𝑛 𝑒𝑎𝑐ℎ 𝑚𝐿 𝑜𝑓 𝑝𝑙𝑎𝑠𝑚𝑎 hormone-receptor complex
● Hormones are “cleared” from the plasma by: ○ Alters the function of the receptor itself
○ Metabolic destruction by the tissues ○ Activated receptor initiates the hormonal effects
○ Binding with the tissues ● 4 types of intracellular signaling or receptor activation:
○ Excretion by the liver into bile ○ Ion channel-linked receptors
○ Excretion by the kidneys into urine ■ Neurotransmitters combine with receptors in the
● Water soluble hormones (peptide & catecholamines) circulate postsynaptic membrane
freely in the blood ● Causes a change in the structure of the
○ Usually degraded by enzymes in the blood & tissues receptor, usually opening or closing a
■ Rapidly excreted by the kidney & liver, thus channel for one or more ions
remaining in the blood for only a short time ● Altered movements of these ions through
○ Plasma protein-bound hormones the channels causes the subsequent effects
■ Much slower clearance rates from blood on the postsynaptic cells (target cells)
■ May remain in circulation for several hours or even ○ G Protein-linked receptors
days ■ When the hormone activates the receptor, the
inactive alpha, beta, & gamma protein complex
associates with the receptor and is activated, with
MECHANISMS OF ACTION OF HORMONES
an exchange of Guanosine Triphosphate (GTP) for
Hormone Receptors & Their Activation Guanosine Diphosphate (GDP)
■ This causes the alpha subunit to which the GTP is
bound to dissociate from the beta and gamma
● The first step of a hormone’s action is to bind to specific
subunits of the G protein and to interact with
receptors at the target cell
membrane-bound target proteins that initiate
○ Cells that lack receptors for the hormones do not respond
intracellular signals
● Binding with receptor usually initiates a cascade of reactions in
the cell, with each stage becoming more powerfully activated
● Locations of different types of hormone receptors:
○ In or on the surface of the cell membrane
■ Mostly for protein, peptide & catecholamine
hormones
○ In the cell cytoplasm
■ For different steroid hormones; found mainly in the
cytoplasm
○ In the cell nucleus ○ Enzyme-linked hormone receptors
■ For the thyroid hormones; believed to be located in ■ An enzyme-linked receptor—the leptin receptor.
direct association with one or more of the The receptor exists as a homodimer (two identical
chromosomes parts), and leptin binds to the extracellular part of
the receptor, causing phosphorylation and
Number & Sensitivity of Hormone Receptors activation of the intracellular associated janus
kinase 2 (JAK2).
■ This causes phosphorylation of signal transducer
● Number of receptors in a target cell usually doesn’t remain
and activator of transcription (STAT) proteins,
constant
which then activates the transcription of target
○ Receptor proteins are often inactivated or destroyed
genes and the synthesis of proteins. JAK2
during the course of their function
phosphorylation also activates several other
○ At other times, they are reactivated or new ones are
enzyme systems that mediate some of the more
manufactured by the protein-manufacturing mechanism of
rapid effects of leptin.
the cell
● Down-regulation can occur as a result of
■ Inactivation of some of the receptor molecules
■ Inactivation of some of the intracellular protein
signaling molecules
 ● cAMP is not the only second messenger used by the different
hormones
● 2 other especially important ones are:
○ Calcium ions & associated calmodulin
○ Products of membrane phospholipid breakdown

Hormones That Act Mainly on Genetic Machinery of the Cell

● Steroid Hormones increase protein synthesis

○ Another means by which hormones act - specifically, the
steroid hormones secreted by the adrenal cortex, ovaries,
and testes - is to cause synthesis of proteins in the target
cells
○ These proteins then function as enzymes, transport
proteins, or structural proteins, which in turn provide other
functions of the cells
● Thyroid Hormones increase gene transcription in the cell nucleus
○ Activate the genetic mechanisms for the formation of
○ Intracellular hormone receptors & activation of genes many types of intracellular proteins - probably 100 or more
■ Mechanisms of interaction of lipophilic hormones, ○ Many of these are enzymes that promote enhanced
such as steroids, with intracellular receptors in intracellular metabolic activity in virtually all cells of the
target cells. After the hormone binds to the body
receptor in the cytoplasm or in the nucleus, the ○ Once bound to the intranuclear receptors, the thyroid
hormone-receptor complex binds to the hormone hormones can continue to express their control functions
response element (promoter) on the DNA. This for days or even weeks
either activates or inhibits gene transcription,
formation of messenger RNA (mRNA), and protein
synthesis. PITUITARY GLAND

● “Master gland”
● Also called the hypophysis
● Lies in the sella turcica
● Connected to the hypothalamus by the pituitary (or hypophysial)
stalk
○ Pituitary is highly related to the hypothalamus
● Parts:
○ Anterior pituitary or adenohypophysis - mostly the
glandular part of pituitary gland
○ Posterior pituitary or neurohypophysis - highly correlated
with neurological function

Second Messenger Mechanism for Mediating Intracellular

Hormone Functions

● Stimulate formation of the second messenger cAMP inside the

cell membrane (one of the means by which hormones exert
intracellular actions)
○ cAMP causes subsequent intracellular effects of the
hormone
○ Only direct effect of the hormone is to activate a single
type of membrane receptor
○ Second messenger does the rest ○ Anterior pituitary - made up of glandular cells; mostly
endocrine in function
○ Posterior pituitary - mostly neurological in function but still
produces specific hormones that affect body functioning
○ Hypophyseal stalk - connects pituitary gland to
hypothalamus

ANTERIOR PITUITARY GLAND

● The hormones of the anterior pituitary play major roles in the

control of metabolic functions throughout the body
● Six hormones: 5 of which are stimulating in function; they act on
other glands to produce other hormones; the other one is Growth
Hormone
○ Growth Hormone (GH) - promotes growth of the entire
body by affecting protein formation, cell multiplication,
and cell differentiation
 ■ Protein formation - protein synthesis; production of
Luteinizing hormone Causes ovulation and formation of the corpus
protein fibers, specifically in areas/regions that (LH) luteum in the ovary; stimulates production of
require protein estrogen and progesterone by the ovary;
■ Cell multiplication - mitosis stimulates testosterone production by the
■ Cell differentiation - cells mature into their own testis; acts upon production of
functioning; e.g. body cells start from stem cells gender-specific hormones
then become other cells such as RBCs, Prolactin (PRL) Responsible for production and secretion of
lymphocytes, immune cells, skin cells, or organ milk
cells
● All the major anterior pituitary hormones, except for growth
○ Adrenocorticotropic Hormone (corticotropin) (ACTH) -
hormone exert their principal effects by stimulating target glands
controls the secretion of some of the adrenocortical
○ Include thyroid gland, adrenal cortex, ovaries, testicles,
hormones, which affect the metabolism of glucose,
and mammary glands
proteins, and fats
■ Hormones that act on adrenal glands, specifically
cortex POSTERIOR PITUITARY GLAND
○ Thyroid-stimulating Hormone (thyrotropin) (TSH) - controls
the rate of secretion of thyroxine and triiodothyronine by ● Cells in supraoptic & paraventricular nuclei of the hypothalamus
the thyroid gland ○ Secrete posterior pituitary hormones
■ These hormones control the rates of the most ○ Hormones are then transported in the axoplasm of the
intracellular chemical reactions (metabolism) in the neurons’ nerve fibers passing from the hypothalamus to
body the posterior pituitary gland.
■ Stimulates the production of thyroid hormones by ● Hormones
the follicular cells ○ Antidiuretic hormone (vasopressin)
○ Prolactin - promotes mammary gland development and ■ Controls the rate of water excretion into the urine
milk production, especially in lactating women ■ Helps to control the concentration of water in the
○ Gonadotropic hormones - act on gonads; Control growth body fluids
of the ovaries and testes, as well as their hormonal and ○ Oxytocin
reproductive activities ■ Helps express milk from the glands of the breast to
■ Follicle-stimulating hormone (FSH) the nipples during suckling
● Responsible for the development of the ■ Helps in the delivery of the baby at the end of
ovarian follicle gestation
● Regulates spermatogenesis in the testes ■ It is also believed that oxytocin increases during
■ Luteinizing hormone (LH) labor to induce labor and increase contractions
● Causes ovulation & formation of the corpus ● Hypothalamus controls pituitary secretion
luteum in the ovary ○ Almost all secretion by the pituitary is controlled by either
● Stimulates production of estrogen & hormonal or nervous signals from the hypothalamus
progesterone by the ovary
● Stimulates testosterone production by the
HYPOTHALAMIC-HYPOPHYSEAL PORTAL BLOOD VESSELS
testis
○ Gender-specific hormones
● Anterior pituitary
○ Highly vascular with extensive capillary sinuses among the
glandular cells
○ Almost all the blood that enters passes first through
another capillary bed in the lower hypothalamus
○ Blood then flows through small hypothalamic-hypophyseal
portal blood vessels into the anterior pituitary sinuses

HYPOTHALAMIC RELEASING & INHIBITORY HORMONES

Hormone Primary Action on Anterior Pituitary

Thyrotropin-releasing Stimulates secretion of TSH by

hormone (TRH) thyrotropes

Gonadotropin-releasing Stimulates secretion of FSH and LH by

hormone (GnRH) gonadotropes

Corticotropin-releasing Stimulates secretion of ACTH by

Hormone Physiological Actions hormone (CRH) corticotropes

Growth Hormone (GH; Stimulates body growth; stimulates secretion Growth hormone-releasing Stimulates secretion of growth
somatotropin) of IGF-1; stimulates lipolysis; inhibits actions hormone (GHRH) hormone by somatotropes
of insulin on carbohydrate and lipid
metabolism Growth hormone-inhibiting Inhibits secretion of growth hormone
hormone (Somatostatin) by somatotropes
Adrenocorticotropic Stimulates production of glucocorticoids and
hormone (ACTH; androgens by the adrenal cortex; maintains Prolactin-inhibiting hormone Inhibits secretion of prolactin by
corticotropin) size of zona fasciculata and zona reticularis of (PIH) lactotopes
cortex

Thyroid-stimulating Stimulates production of thyroid hormones by

hormone (TSH; follicular cells; maintains size of follicular cells
thyrotropin)

Follicle-stimulating Stimulates development of ovarian follicles;

hormone (FSH) regulates spermatogenesis in the testis
GROWTH HORMONE
 ■ There are cases where stature is short but
● Growth hormone does not function through a target gland but proportion is off (small torso, small limbs, but large
exerts its effects directly on all or almost all tissues of the body head; this is caused by chondrodysplasia)
○ Panhypopituitarism in the Adult
■ General effects:
METABOLIC EFFECTS OF GROWTH HORMONE
● Hypothyroidism - under-secretion of thyroid
hormones due to decreased release of
● General effect in causing growth
thyroid-stimulating hormone
● Other specific metabolic effects
● Depressed production of glucocorticoids by
○ Increased rate of protein synthesis in most cells of the
the adrenal glands - due to decrease of
body
ACTH
○ Increased mobilization of fatty acids from adipose tissue,
● Suppressed secretion of the gonadotropic
increased free fatty acids in the blood, and increased use
hormones so that sexual functions are loss
of fatty acids for energy
● Lethargic person (from lack of thyroid
○ Decreased rate of glucose utilization throughout the body
hormones)
● In effect, growth hormone:
● Who is gaining weight (because of lack of
○ Enhances body protein
fat mobilization by growth,
○ Uses up fat stores
adrenocorticotropic, adrenocortical, and
○ Conserves carbohydrates
thyroid hormones); person is stocky
● Remember: growth hormone is responsible for utilization of fat,
because fat is distributed in a non
protein synthesis (to grow muscle)
proportional manner
● And has lost all sexual functions
Stimulate Growth Hormone Inhibit Growth Hormone ● Gigantism
Secretion Secretion ○ Hypersecretion of GH
○ Growth hormone-producing cells of the anterior pituitary
Decreased blood glucose Increased blood glucose
Decreased blood free fatty acids Increased blood free fatty acids gland become excessively active
Starvation or fasting, protein Aging ■ All body tissues grow rapidly, including the bones
deficiency Obesity ■ If the condition occurs before adolescence, height
Trauma, stress, excitement Growth hormone inhibitory increases so that the person becomes a giant up
Exercise hormone (somatostatin) to 8 feet tall
Testosterone, estrogen Growth hormone (exogenous) ● Acromegaly
Deep sleep (stages II and IV) Somatomedins (insulin-like growth
○ Pituitary tumor occurs after adolescence
Growth hormone-releasing factors)
hormone ○ The person cannot grow taller, but the bones become
thicker and the soft tissues can continue to grow
○ Enlargement is especially marked in the bones of the:
● Growth hormone preserves glucose so when there is a decrease
■ Hands and feet
in blood glucose, it will decrease the consumption of glucose to
■ Membranous bones, including the cranium, nose,
preserve glucose and conserve carbohydrates
bosses on the forehead, supraorbital ridges, lower
● Free fatty acids are fatty acids that are present in the bloodstream
jawbone, and portions of the vertebrae, because
and utilized by the body. When there is a decrease in that, that
their growth does not cease during adolescence
means most of the fat is stored in adipose tissue. It stimulates GH
■ The sum of bones become bigger because of the
to utilize the fat that are stored in adipose and increase free
membranous origin
floating fatty acids in the bloodstream.
■ Cartilaginous bones cease to grow during a
● GH is stimulated during protein deficiency because there should
specific time in adolescence while membranous
be protein synthesis. Starvation and fasting uses up a lot of
bones don’t cease to grow after adolescence (they
glucose and decreases protein synthesis.
can grow in the right circumstances, esp. with
● Testosterone and estrogen are helpful in the release of GH esp.
secretion of GH)
during production of secondary sex characteristics
○ Consequently
● Stages II and IV - REM sleep (rapid eye movement); a very
■ Lower jaw protrudes forward
important part of sleep cycle
■ Forehead slants forward because of excess
○ This is why it is partly true that if you don’t sleep enough,
development of the supraorbital ridges
you won’t grow properly because GH is
■ Nose increases to as much as twice normal size
released/stimulated during sleep
■ Feet require size 14 or larger shoes
■ Fingers become extremely thickened so that the
ABNORMALITIES OF GROWTH HORMONE SECRETION hands are almost twice normal size
■ Changes in the vertebrae: kyphosis
● Panhypopituitarism ■ Many soft tissue organs: tongue, liver, kidneys
○ “Pan” meaning all, so all hormones become greatly enlarged
○ Decreased secretion of all the anterior pituitary hormones ○ Gigantism vs acromegaly
■ May be congenital (present from birth) ■ Gigantism - proportionally correct
■ May occur suddenly or slowly at any time during ■ Acromegaly - malproportioned
life
■ Most often resulting from a pituitary tumor that THYROID GLAND
destroy the pituitary gland; a tumor that
compresses the pituitary gland → causing haywire
● Major hormones (thyroid hormones)
functioning of adenohypophysis → decreased
○ Thyroxine (T4) - usually most abundant
secretion of hormones
○ Triiodothyronine (T3) - more potent than thyroxine but
○ Dwarfism
present in smaller amounts
■ Generalized deficiency of anterior pituitary
○ These hormones profoundly increase the metabolic rate of
secretion (panhypopituitarism) during childhood
the body (chemical reactions, cellular activities)
■ All the physical parts of the body develop in
● Calcitonin, an important hormone for calcium metabolism (lowers
appropriate proportion to one another, but the rate
blood calcium by stimulating the body to metabolize and excrete
of development is greatly decreased
calcium or store it where it is needed, such as in the bones)
■ “Miniature people'' due to release of GH
 ● Causes of Hyperthyroidism
PHYSIOLOGIC ANATOMY OF THE THYROID GLAND
○ Autoimmune
○ Gland size is increased to two to three times
● Thyroid gland is composed of:
○ With tremendous hyperplasia and infolding of the follicular
○ Large numbers of closed follicles filled with a secretory
cell lining into the follicles
substance called colloid and
○ Some of these hyperplastic glands secrete thyroid
○ Lined with cuboidal epithelial cells (usually secretory in
hormone at rates 5 to 15 times normal
function) that secrete into the interior of the follicles
● Symptoms
○ Major constituent of colloid is the large glycoprotein
○ High state of excitability - stimulation and response time
thyroglobulin (primitive thyroid hormone), which contains
are greatly increased; very responsive to the point of
the thyroid hormones
anxiety and stress
○ Once the secretion has entered the follicles, it must be
○ Intolerance to heat - increase in metabolism increases
absorbed back through the follicular epithelium into the
body temperature
blood before it can function in the body
○ Increased sweating - correlated with periods of excitement
and fight/flight mode due to increased metabolism
PHYSIOLOGIC ANATOMY OF THE THYROID GLAND ○ Mild to extreme weight loss - metabolism affects ability to
consume food and convert them to energy
● Iodine is required for formation of thyroxine ○ Varying degrees of diarrhea
● Metabolically active hormones ○ Muscle weakness - due to rate of protein synthesis and
○ Thyroxine - about 93% catabolism; protein fibers may be premature and weaker
■ Larger amounts present but less potent ○ Nervousness or other psychic disorders - constant
○ Triiodothyronine - 7% fight/flight, stress, anxiety; mental processing is increased
■ More potent; stronger form of thyroid hormones so mental functions are highly excitable, unable to shut
■ Smaller amounts present down thoughts causing psychological problem
■ Can be converted to thyroxine in the presence of ○ Extreme fatigue but inability to sleep - fatigue due to
iodine constant fight/flight or stress but unable to shut down
● Almost all the thyroxine is eventually converted to triiodothyronine body so they can’t sleep
in the tissues, so both are functionally important ○ Tremor of the hands
● Functions of these hormones are qualitatively the same, but differ ○ Exophthalmos - inward growth of thyroid glands which
in rapidity and intensity of action compresses the cavity or neck → increased pressure
○ T3 is about four times as potent as T4 below and above thyroid → increases pressure above
○ T3 present in the blood in much smaller quantities and ■ Eyes are bulging
persists for a much shorter time than does T4
● TSH Increases thyroid secretion HYPOTHYROIDISM
○ TSH (thyrotropin) from anterior pituitary increases the
secretion of thyroxine and triiodothyronine by the thyroid
● Probably autoimmunity against the thyroid gland that destroys the
gland
gland rather than stimulate it
● Other types of hypothyroidism also occur, often associated with
EFFECTS OF THYROID HORMONE development of enlarged thyroid glands, called thyroid goiter
● Endemic Colloid Goiter caused by dietary iodide deficiency
● Thyroid hormones increase the transcription of large numbers of ○ Lack of iodine prevents production of both thyroxine and
genes triiodothyronine
○ General effect of thyroid hormones ○ No hormone is available to inhibit production of TSH by
■ Synthesize great numbers of protein enzymes, the anterior pituitary
structural proteins, transport proteins, and other ■ Causes the pituitary to secrete excessively large
substance quantities of TSH
○ Net result is generalized increase in functional activity ○ TSH then stimulates the thyroid cells to secrete
throughout the body tremendous amounts of thyroglobulin colloid into the
● Thyroid hormones increase cellular metabolic activity follicle sand the gland grows larger and larger
○ Basal metabolic rate can increase to 60 to 200% above ○ Because of lack of iodine, thyroxine and triiodothyronine
normal with increased secretions production does not occur in the thyroglobulin molecule
○ Rate of utilization of foods for energy is greatly accelerated ■ No normal suppression of TSH production by the
○ Rate of protein synthesis (production of protein) is anterior pituitary
increased at the same time the rate of protein catabolism ○ Follicles become tremendous in size and the thyroid gland
(breakdown of protein) is also increased may increase to 10-20 times normal
○ Growth rate of young people is greatly accelerated ● Physiologic characteristics of hypothyroidism
○ Mental processes are excited ○ Fatigue and extreme somnolence with sleeping up to
○ Activities of most of the other endocrine glands are 12-14 hours a day
increased ■ “bug-at ilihok” due to lack of energy
○ Extreme muscular sluggishness - slow in moving
○ Slowed heart rate, decreased cardiac output, decreased
blood volume
○ Sometimes increased body weight - unable to digest food
to use as energy
○ Constipation
○ Mental sluggishness
○ Failure of many trophic functions in the body evidenced by
depressed growth of hair and scaliness of the skin
○ Development of a frog like husky voice
DISEASES OF THYROID HORMONE
○ In severe cases, development of an edematous
HYPERTHYROIDISM appearance throughout the body called myxedema
(Toxic Goiter, Thyrotoxicosis, Graves’ Disease) ● Myxedema
○ Develops in the patient with almost total lack of thyroid
hormone function
 ○ Demonstrating bagginess under the eyes and swelling of
the face
○ Excessive tissue gel in the interstitial spaces which causes
the total quantity of interstitial fluid to increase
○ The gel nature of the excess fluid is mainly immobile
○ Severe case of hypothyroidism in adults
● Cretinism
○ Caused by extreme hypothyroidism during fetal life,
infancy, or childhood
○ Characterized by failure of body growth and mental
retardation
○ Results from
■ Congenital lack of a thyroid gland (congenital
cretinism)
■ Failure of the thyroid gland to produce thyroid
hormone because of a genetic defect of the gland
or from iodine lack in the diet (endemic cretinism)
○ Skeletal growth is characteristically more inhibited than is
soft tissue growth
■ Thyroid is responsible for deposition of calcium
into bones
■ Here, there is a decrease in blood calcium so the
bones will not receive enough calcium to mineralize
○ Soft tissues are likely to enlarge excessively
■ Giving the child with cretinism an obese, stocky,
and short appearance
■ Occasionally the tongue becomes so large that it
obstructs swallowing and breathing, inducing a
characteristic guttural breathing that sometimes
chokes the child
○ Take note of hypotonic posture, coarse facial features, and
umbilical hernia
● Goiter

Read:
Guyton & Hall Textbook of Medical Physiology, 13th Ed.
Chapter 76: Pituitary Hormones and Their Control by the
Hypothalamus
Chapter 77: Thyroid Metabolic Hormones