How does your Thyroid work?

Excerpted from The Harvard Medical School Guide to Overcoming Thyroid Problems by Dr. Jeffrey R. Garber, published by McGraw-Hill

Think of your thyroid as a car engine that sets the pace at which your body operates. An engine produces the required amount of energy for a car to move at a certain speed. In the same way, your thyroid gland manufactures enough thyroid hormone to prompt your cells to perform a function at a certain rate.

Just as a car can’t produce energy without gas, your thyroid needs fuel to produce thyroid hormone. This fuel is iodine. Iodine comes from your diet and is found in iodized table salt, seafood, bread, and milk. Your thyroid extracts this necessary ingredient from your bloodstream and uses it to make two kinds of thyroid hormone: thyroxine, also called T4 because it contains four iodine atoms, and triiodothyronine, or T3, which contains three iodine atoms. T3 is made from T4 when one atom is removed, a conversion that occurs mostly outside the thyroid in organs and tissues where T3 is used the most, such as the liver, the kidneys, and the brain.

Once T4 is produced, it is stored within the thyroid’s vast number of microscopic follicles. Some T3 is also produced and stored in the thyroid. When your body needs thyroid hormone, it is secreted into your bloodstream in quantities set to meet the metabolic needs of your cells. The hormone easily slips into the cells in need and attaches to special receptors located in the cells’ nuclei.

Your car engine produces energy, but you tell it how fast to go by stepping on the accelerator. The thyroid also needs some direction; it gets this from your pituitary gland, which is located at the base of your brain. No larger than a pea, the pituitary gland is sometimes known as the “master gland” because it controls the functions of the thyroid and the other glands that make up the endocrine system. Your pituitary gland sends messages to your thyroid gland, telling it how much thyroid hormone to make. These messages come in the form of thyroid-stimulating hormone (TSH).

TSH levels in your bloodstream rise or fall depending on whether enough thyroid hormone is produced to meet your body’s needs. Higher levels of TSH prompt the thyroid to produce more thyroid hormone. Conversely, low TSH levels signal the thyroid to slow down production.

The pituitary gland gets its information in several ways. It is able to read and respond directly to the amounts of T4 circulating in the blood, but it also responds to the hypothalamus, which is a section of the brain that releases its own hormone, thyrotropin-releasing hormone (TRH). TRH stimulates TSH production in the pituitary gland. This network of communication between the hypothalamus, the pituitary gland, and the thyroid gland is referred to as the hypothalamic-pituitary-thyroid axis (HPT axis).

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