RT Book, Section A1 Blake, Elizabeth W. A2 Sutton, S. Scott SR Print(0) ID 1158316462 T1 Thyroid Disorders T2 McGraw-Hill's NAPLEX® Review Guide, 3e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9781260135923 LK accesspharmacy.mhmedical.com/content.aspx?aid=1158316462 RD 2022/05/16 AB The thyroid gland is located in the front of the neck and operates via negative feedback to synthesize thyroid hormones. The hypothalamus produces thyrotropin-releasing hormone (TRH) which stimulates the pituitary to release thyroid-stimulating hormone (TSH). TSH, also known as thyrotropin, stimulates the synthesis and release of thyroid hormones from the thyroid gland. Formation of thyroid hormones requires iodination of tyrosine residues by thyroid peroxidase to produce monoiodinated and diiodinated residues that couple to form triiodothyronine (T3) and levothyroxine (T4). Circulating levels of T3 and T4 regulate TSH secretion via negative feedback. The thyroid gland is responsible for the production of T4 and less than 20% of T3. Peripheral conversion of T4 to T3 forms the majority of T3. Compared to T4, T3 is more potent, less bound to plasma proteins, and has a shorter half-life. Thyroid hormones affect multiple organ systems throughout the body and alterations in hormone concentrations and TSH lead to hyper- or hypothyroidism (Tables 62-1 and 62-2).