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Synthesis and Regulation of Thyroid Hormones

Synthesis 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.
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Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...

Hyperthyroidism I: Introduction

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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...

Hyperthyroidism II: Pathophysiology

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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...

Graves' Disease I: Introduction

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...

Graves Disease II: Pathophysiology

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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...

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Poisoning with Thyroid Hormones Used Illegally-Systematic Review.

Monika Skrzypiec-Spring¹, Krzysztof Kujawa², Anna Wietrzyk¹

¹Department of Pharmacology, Faculty of Medicine, Wroclaw Medical University, 50-345 Wroclaw, Poland.

Pharmaceuticals (Basel, Switzerland)

|December 31, 2025

Summary

Thyroid hormone abuse for performance enhancement and weight loss is increasing, particularly among athletes. Overuse can lead to severe health issues, including poisoning, with a notable rise in cases since 2015.

Keywords:

drug abuse poisoning public health impact thyroid hormones toxicological effects

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Area of Science:

Endocrinology
Toxicology
Public Health

Background:

Thyroid hormones are essential for metabolism but are misused for non-medical purposes like performance enhancement, weight loss, and suicide attempts.
Despite therapeutic safety, overuse of thyroid hormones can cause severe health consequences, including fatalities.
Limited research exists on the scale, characteristics, and outcomes of illegal thyroid hormone use.

Purpose of the Study:

To analyze case reports of thyroid hormone poisoning over the past 30 years.
To assess trends and characteristics of illegal thyroid hormone use and its associated poisoning cases.

Main Methods:

Systematic review of full-text clinical case studies from major scientific databases (PubMed, Scopus, etc.).
Search terms included "thyroid hormones," "thyroxine," "levothyroxine," "triiodothyronine," "liothyronine," and "poisoning," "overdose," "intoxication."
Adherence to Preferred Reporting for Systematic Reviews and Meta-analyses (PRISMA) guidelines.

Main Results:

Thyroid hormone abuse is prevalent among athletes, individuals seeking weight loss, and those attempting suicide.
A significant upward trend in thyroid hormone poisoning cases has been observed since 2015, linked to doping and performance enhancement.
Suicide-related thyroid hormone poisonings have remained stable since 2017.

Conclusions:

Thyroid hormone poisoning, primarily linked to illicit use alongside anabolic-androgenic steroids, shows an increasing trend.
Thyroid hormone abuse represents a significant concern within suicidology.
Further research is warranted to understand and mitigate the risks of thyroid hormone misuse.