Discovery illuminates how thyroid hormone 'dims... - Thyroid UK

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Discovery illuminates how thyroid hormone 'dims' metabolism

helvella profile image
helvellaAdministratorThyroid UK
8 Replies

I'm pretty sure that many involved with thyroid issues - patients or professionals - have wondered exactly how thyroid hormone actually works.

This paper - summary and abstract are available, full paper is behind a paywall - suggests some progress in understanding.

I note use of the phrase "the canonical model" - afraid, in my book, it has not been a model at all. It has been misguided assumption.

One sentence:

The researchers showed when thyroid hormone is bound to TRβ, it can shift the balance of these associated co-regulator proteins in favor of more gene activation at some sites, and more gene repression at others.

We see, time and again, that as we approach our optimum thyroid hormone dose - it gets more and more difficult to appreciate whether we are slightly under- or over-dosed. I suggest that time might also be critical. With variations in thyroid hormone being far more important than previously appreciated.

Can you imagine in a fully healthy person, the levels vary dynamically. Whereas in a once a day dosing, we have an entirely different pattern. It might even be that those who take one dose of T3 a day end up with individual cells changing balance (as described above) through the day - and this being somehow better than permanently being slightly under- or over-dosed.

News Release 17-Feb-2021

Discovery illuminates how thyroid hormone 'dims' metabolism

University of Pennsylvania School of Medicine

Research News

It has been known for some time that the thyroid gland is a strong regulator of the body's metabolism, making it key to many health conditions. But the molecular details of how thyroid hormone acts on cells in the body have never been fully understood. Now researchers at the Perelman School of Medicine at the University of Pennsylvania have taken a big step toward the resolution of this mystery by showing that it doesn't operate as a straight on/off switch, but more like a dimmer.

Biologists have known that, in cells where thyroid hormone acts to regulate metabolism, it operates in the cell nucleus, increasing the activity of some genes and decreasing the activity of others. The details of how the hormone controls gene activity have been mostly unknown, due to technical hurdles that have made it difficult to study them. The Penn Medicine researchers, who report their discovery today in Genes and Development, were able to overcome many of these technical hurdles to provide a much clearer picture of thyroid hormone's basic mechanisms of action -- in the process overturning other prominent models of these mechanisms.

"We were able in this study to show that thyroid hormone doesn't just turn things on or off, as the canonical model suggests, but instead more subtly shifts the balance between the repression and enhancement of gene activity," said principal investigator Mitchell Lazar, MD, PhD, Ware professor of Diabetes and Metabolic Diseases, and the director of the Institute for Diabetes, Obesity and Metabolism, at Penn Medicine. "Yet, as people with hypothyroidism know, the lack of thyroid hormone can have profound effects on the body."

Diseases of the thyroid gland, including hypothyroidism, hyperthyroidism, and goiter, have been described for as long as there have been doctors. The thyroid-produced molecule thyroxine, the chemical precursor to the main active form of thyroid hormone, was identified in 1914.

Endocrinologists also have long recognized that thyroid hormone is an essential metabolism-enhancing regulator whose insufficiency can lead not only to obvious thyroid diseases but also to weight gain and related metabolic problems including diabetes, high cholesterol, and fatty liver disease. Thus, the hormone's mechanism of action, if understood, could be a drug target of enormous value for medicine.

But although scientists have known for almost 40 years that thyroid hormone acts in the cell nucleus to control gene activity by binding itself to special proteins called thyroid hormone receptors, how it all works has remained an enigma -- largely because the interactions of thyroid hormone and its receptors have been difficult to study. Among other challenges, the receptors normally are produced in relatively tiny quantities in cells, and scientists have lacked a good way to mark their binding sites on DNA -- and to see how these binding sites differ when thyroid hormone is present.

In the new study, for which Yehuda Shabtai, PhD, a postdoctoral researcher in the Lazar lab, served as lead author, the researchers developed a mouse model in which a special tag was added to TRβ, the main thyroid hormone receptor in the liver -- where some of thyroid hormone's most important metabolic effects occur. The researchers used this tag for marking the thousands of locations on DNA where TRβ binds, both in a condition when thyroid hormone was present and could bind to TRβ and also when the hormone was largely absent. With these and other experiments, the team provided strong evidence that thyroid hormone works with TRβ in an unexpectedly subtle way.

When it binds to a given site on coiled DNA in the nucleus, TRβ will enhance or repress the activity of a nearby gene or genes. To achieve this, it forms complexes with other proteins called co-activators and co-repressors. The researchers showed when thyroid hormone is bound to TRβ, it can shift the balance of these associated co-regulator proteins in favor of more gene activation at some sites, and more gene repression at others. This is in contrast to prior models of thyroid hormone / TRβ function in which thyroid hormone has a more absolute, switch-like effect on gene activity.

The researchers acknowledge that more work needs to be done to elucidate why thyroid hormone's binding to TRβ lowers gene activity at some sites on DNA, and increases gene activity at other sites. But they see the new findings as a significant advance in understanding a basic process in biology -- a process that future medicines may be able to target precisely to treat a variety of metabolic diseases.

Co-authors on this study include Yehuda Shabtai, Nagaswaroop Nagaraj, Kirill Batmanov, Young-Wook Cho, Yuxia Guan, Chunjie Jiang, Jarrett Remsberg, Douglas Forrest, and Mitchell Lazar.

eurekalert.org/pub_releases...

Abstract freely available here (and full paper, behind paywall):

genesdev.cshlp.org/content/...

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helvella
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Triciatextiles profile image
Triciatextiles

Interesting read. Its good to know research is being carried out.

helvella profile image
helvellaAdministratorThyroid UK in reply to Triciatextiles

Couldn't agree more.

Just devastating that we are here, almost a century after the first synthesis of levothyroxine in 1927, and still at this level of ignorance. With much about treatment based on hunches, guesses, assumptions - along with some startlingly excellent science.

Triciatextiles profile image
Triciatextiles in reply to helvella

Totally agree. I have nine close family members with hypothyroidism including my husband and both my children, it’s staggering how little even endocrinologists know about the disease or how to treat patients.

jgelliss profile image
jgelliss in reply to helvella

Helvella Thank you for this great study. Though more much more studies are needed . But this is a very positive and hopeful beginning. I would in addition love it if studies can be done on why some do great on T4 and T3. While some do great on either T4 sole or T3 sole? I know that from my personal experiences after my TT I was dosed with T4 sole doing very well . But with time many symptoms aroused. Tried some T3 not doing very well later tried NDT with T4 at first doing very well . Then experienced aches/pains . And now on T4 sole with much less aches/pain.

So yes much-needed studies needed.

humanbean profile image
humanbean

Personal anecdote...

I couldn't tolerate Levo when I first started treatment, so quickly decided to treat myself. I've spent most of the time since then on T3 only. But eventually I started getting a lot of episodes of tachycardia. I tried Levo again, and to my surprise I tolerated it. My nutrient levels are much better now than they were at the start of treatment.

But one effect of the Levo has been to pile on the pounds. I'm probably around 30lbs heavier now than I was when I was just on T3. And I wasn't exactly sylph-like on just T3.

If I was to mention this weight gain to a doctor I'm sure they would tell me that I just have to "eat less and move more", and they would insist that "normal" people lose weight on Levo. :(

tattybogle profile image
tattybogle

*newsflash*

Scientists discover that the human body's system of maintaining homeostasis in the face of extremes from climate, illness, starvation, pregnancy, excess cocoa cola intake , and life in general is, in fact .... Hugely Complicated (well, there's a surprise !) ,

and the previous 'model' of treatment based on the "Ladybird Book of TSH", and "trying to build an effective replacement for an intricate thyroid hormone out of Lego (Levo )" is a crap idea and unlikely to provide a good enough solution to the problem.

Hurrah. well done .

nellie237 profile image
nellie237

Thank you, really interesting😀

FancyPants54 profile image
FancyPants54

I'm feeling dim today, I'm extremely stressed over work. Can someone tell me, is the take-out of this that taking 1 dose a day of T3 might be better than splitting it?

I'm now taking 20mcg T3 a day in 2 doses and 125 Levo and I feel no benefit at all. Time for next blood test next week.

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