Educational picture

Educational picture

When I was initially diagnosed with Hashi's & Hypo I found all the acronyms, and "stuff" quite overwhelming with little available in the way to "simplify" it all for me.

So, being a visual person who enjoys trying to simplify complex things to make it more easily understood, I put together the following diagram to "educate" myself.

Over the past few weeks, in various forums, I have seen questions being asked by newly diagnosed people about how the thyroid works, what is TSH, etc, etc. & thought it might be an idea to share what I had put together. This is the first in a series I have done & thought I'd ask for feedback from all you good folk :)

Constructive criticism welcomed (if I've gotten anything wrong in my understanding of how it all works) - is it a good thing / idea to share or is this a fruitless quest ??

22 Replies

  • Definitely, very interesting indeed. I think it's great and informative. 

    Reading the above when the person has absolutely no knowledge of the work of the thyroid gland (I'm one of them) - feeling very unwell, it's great to have your diagram which is self-explanatory.

    You could also email it to and ask if they would like to use it in their Harmony Magazine.

    Harmony Magazine is issued quarterly to members and cost of membership is £20 per annum.

    I've been behind in my reading and have just caught up this afternoon on the latest issue which is full of the updates and what's happening in the future etc. to promote the awareness of thyroid gland dysfunctions.

    Thanks again.

  • Thanks Shaws - there are a couple of other pages which I need to tidy up a little & I will send them all over to Louise when I'm done.

    I will also post them all here for everyone as well :)

  • Thankyou, anything that makes it easier to understand is good for me! :)

  • budd_james.

    Its brilliant. You could add the percentages .....

    The thyroid produces roughly 7% T3 & 93% T4 that must be converted before use.

    The liver converts most of this T4 but other organs (kidney, heart, etc), the pituitary, muscle and peripheral tissues are involved. Approximately sixty percent of the T4 is converted into T3, twenty percent into RT3 and the remaining twenty percent is converted into T3S (T3 sulphate) and T3AC (triiodothyroacetic acid) which may then convert to T3 in the gut with favourable conditions. 

    The enzyme largely responsible for thyroid hormone conversion is 5′ deodinase but it comes in three forms: deodinase type I (D1) that works throughout the body,  deodinase type II (D2) which works in the pituitary and deodinase type III (D3) which converts to both active and reverse T3. 


    A simplistic explanation for your graph might read ......

    D1 Increases cellular thyroid activity, is resilient to toxins and medications but can be suppressed by stress factors (both physiologic and emotional).

    D2 is 1000 more efficient at conversion than D1 and has different behavioural patterns being up regulated by stress, dieting ,etc.  D2 activity may increase pituitary T3 levels whilst simultaneously suppressing cellular T3 levels.

    D3 is present in all tissues except pituitary and competes with D1, converting T4 to RT3.


    You could also add in the 2 metabolic pathways in the liver: glucoronidation pathway & sulfation as both synthesis//detoxify thyroid hormones in different ways.. 

  • Wow - that's brilliant Radd - many thanks - will do my best to put all that in. Also need to add in the adrenals somewhere along the line :)

  • Arrr ... your graph is growing budd.

    I'll have think of any other important considerations too. 

  • Yes, the HPA axis needs to be incorporated.

    HPT axis stimulates the thyroid and HPA axis responds to stress  in a correlated manner to affect the biochemical pathway that produce good levels of T3.

    I think healthy amounts of all hormones important but as cortisol and DHEA-S compete for the same precursor pregnenolone, raised cortisol will encourage inadequate amounts of DHEA-S which is the precursor of sex hormones, oestrogen and testosterone.

  • I've got a partially complete diagram of how the HPA & HPT is affected by stress & what happens to the thyroid hormones. Need to finish it though.....

    Currently working on a thyroid nutritional diagram to explain where the vitamins fit into the "scene" & which ones "nourish" different parts of the process......

  • great stuff. I'm bamboozled ;-)

  • Point 7...   The bit about excess t4 and t3 being converted to rt3...      T4 can lose an iodine atom and depending on where it loses it, can become t3 or rt3..   But t3 cant move an atom to become rt3.    It can lose an atom to become T2 though....       Any chemistry experts out there please?     


  • My wording that's at fault Galathea.

    Will adjust the sentence to avoid the confusion. Many thanks for highlighting that.

  • Brilliant . Just wish I could print it out !

    Thank you

  • If you right click on the picture you can save it to you computer & print it from there. Let me clean up the remainder in the series then I'll also put them up on a web site so people can save them from there. Alternatively I'm happy to email a better copy to anyone who is interested.  :)

  • Thank will try right click method

  • Budd,

    With the exception of what is made in the thyroid gland, T3 is produced by peripheral conversion from T4 in the deiodination reaction removing one iodine from the outer ring of T4, some of which are recycled and the rest excreted.

    Re Galathea's observation, maybe point 7 could read as "excess unused T4 may be  converted to RT3 or excreted mainly via the liver in fecal matter. A small amount of RT3 is essential to balance excess T4 & T3 to prevent a hyper state." 

    If you wanted to explain further you could investigate how T4 & T3 are initially iodine based compounds that when incorporated into thyroglobulin form MIT & DIT.

    You could also mention T1, T2 and calcitonin. 

  • budd_james, T4 is also stored in the kidneys.

    There's other papers but this is the first one that popped up.  

  • Interesting.

    Thank you.

  • Hi radd, are you an endocrinologist because you know a lot more than some doctors.

  • Thanks everyone for your feedback - it's great stuff :)

    Looking at it all I am now leaning more towards a series of infographics rather than trying to fit all the wonderful suggestions into one - an all in one might prove to be overwhelming IMHO & I feel the infographic needs to be fairly simple for the newly diagnosed :)

    Maybe I can also put together some infographics that people could print out & take to their Dr to help explain where they have concerns ...... thinking of things like explaining weight gain when Levo is increased, fatigue, etc. Is that a good idea & if so what topics would you like to see covered ??

    Have some time on my hands at the moment so that would keep me occupied ;)

  • Totally agree with you on that, budd_james. Your initial idea was great, but I could see it getting more and more complicated, and losing more and more people along the way.

    We have to remember the reduced capacity for absorbing and retaining information when we have a hypo brain. However, a series of illustrations, adding in a couple more facts in each infographic, would be much easier to grasp.

    People could go at their own speed Learning, and not feel over-whelmed by it all. The more info there is, the less we tend to retain. It's a great idea to build up gradually. Would make a terrific book!  

  • Budd-James,

    I think the diagram is excellent and clearly displays the process. I certainly wouldn't overcomplicate it by adding more information.

    point 7 - Delete T3 - it's T4 which converts to rT3.

    Perhaps lose the T4 down arrow connecting to the rT3 dustbin as it looks as though T4 is going straight to rT3.

  • Budd-James,great ideas  thank you very much. My post TT hypo brain is not the same as it once was but I always have retained visual images far better anyway. I'm really looking forward to seeing your graphics. I reckon they'd be easier for a gp to understand too!  Xx

You may also like...