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Published on: December 7, 2017
Excess thyroid hormone and carbohydrate metabolism
Matthew Potenza1, Michael A Via, Robert T Yanagisawa
1Division of Endocrinology, Diabetes, and Bone Disease, Mount Sinai School of Medicine, New York, New York 10029, USA. matthew.potenza@mssm.edu
Summary
Excess thyroid hormone significantly impacts carbohydrate metabolism, potentially leading to diabetic ketoacidosis in type 2 diabetes patients. Screening for thyroid dysfunction is crucial for managing glucose homeostasis.
Area of Science:
- Endocrinology
- Metabolic Research
Background:
- Thyroid hormone plays a critical role in regulating glucose metabolism.
- Understanding the intricate relationship between thyroid function and carbohydrate metabolism is essential for clinical practice.
Observation:
- Hyperthyroidism influences glucose homeostasis through multiple mechanisms, including increased hepatic glucose production and altered insulin dynamics.
- Thyroid hormone affects skeletal muscle and liver glycogen stores, as well as glucose metabolism pathways.
- Changes in adipokines and adipose tissue function in thyrotoxicosis contribute to ketosis risk.
Findings:
- Thyrotoxicosis can severely disrupt carbohydrate metabolism in type 2 diabetics, potentially causing diabetic ketoacidosis.
- Correcting hyperthyroidism can significantly improve glucose control in diabetic patients.
Implications:
- Diabetic patients should be screened for thyroid dysfunction to optimize glycemic control.
- Patients presenting with diabetic ketoacidosis require thyroid function assessment to rule out underlying hyperthyroidism.
Related Concept Videos
01:25Hyperthyroidism I: Introduction
Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
01:27Hyperthyroidism II: Pathophysiology
Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
01:19Overview of Carbohydrate Metabolism
Carbohydrate metabolism is a fundamental biochemical process that ensures a constant supply of energy to living cells. The most important carbohydrate is glucose, which can be broken down via glycolysis to enter into the Krebs cycle and eventually lead to the production of ATP through oxidative phosphorylation.
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...
01:24Graves Disease II: Pathophysiology
Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...
01:20Synthesis and Regulation of Thyroid Hormones
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...
01:18Functions of Thyroid Hormones
The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...