Pregnancy negates thyroid hormone-induced pyrexia

Nuria López-Alcántara1,2, Lena Adam1,2, Julia Resch2

  • 1Institute for Experimental Endocrinology-Group Thyroid and BAT Programming, Center of Brain Behavior and Metabolism (CBBM), University of Luebeck/UKSH, Luebeck, Germany.

Thyroid hormone (TH) is a key regulator of body temperature; however, its role in the tightly controlled maternal thermoregulatory system that safeguards fetal viability remains unknown. To address this gap, we investigated how maternal hyperthyroidism affects thermoregulation, metabolic tissues, and endocrine signaling in pregnant C57BL/6NCrl mice. Treatment with 3,3',5-triiodo-l-thyronine (T3) from conception to late gestation initially elevated maternal core temperature, reflecting a hypothalamic pyrexic set point. However, this effect was gradually attenuated toward term, permitting the normal prepartum drop in core body temperature. Despite elevated TH levels, brown and white adipose tissues showed no thermogenic activation, whereas skeletal muscle exhibited selective metabolic remodeling, including glycogen depletion and increased mitochondrial capacity in glycolytic muscles, without changes in SERCA2 expression. Notably, maternal T3 treatment further boosted the pregnancy-associated increase in FGF21, whereas adipose tissue remained nonthermogenic, indicating a role of TH-induced FGF21 in sustaining maternal metabolic requirements. Together, these findings reveal a hierarchical adaptation in which central TH effects are overridden, peripheral thermogenic activation is partially suppressed, and endocrine signaling is redirected to maintain maternal-fetal energy balance. In summary, this study identifies a pregnancy-specific mechanism that protects the fetus from hyperthermia while sustaining maternal metabolic demands, with important implications for thyroid dysfunction and fetal programming.NEW & NOTEWORTHY We show that pregnancy attenuates thyroid hormone (TH)-induced pyrexia, consistent with a hierarchical adaptation. This pregnancy-specific mechanism appears to protect the fetus from maternal hyperthermia while redirecting endocrine signaling to meet maternal-fetal energy demands. Importantly, it involves a reprogramming of TH and hepatic FGF21 actions, providing new insights into maternal-fetal energy regulation and the management of thyroid dysfunction during gestation.

Related Concept Videos

Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism 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...
58
Hypothyroidism II: Pathophysiology01:23

Hypothyroidism II: Pathophysiology

Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...
58
Graves Disease II: Pathophysiology01:24

Graves 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,...
59
Hyperthyroidism I: Introduction01:25

Hyperthyroidism 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...
64
Synthesis and Regulation of Thyroid Hormones01:20

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.
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...
7.2K
Graves' Disease I: Introduction01:28

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...
52