The hypothyroid brain

Abstract

 

The thyroid gland is controlled by a feedback system, the hypothalamus-pituitary-thyroid axis, and produces thyroid hormone (TH), which plays a critical role in growth, development and cellular metabolism. Diseases of the thyroid are well defined clinically and biochemically and diseases affecting thyroid function can cause both clinical hypothyroidisms, the most common cause of thyroid dysfunction, occurs when there is a decrease in the production of thyroid hormones, and hyperthyroidism, when there is an increase in hormone production. Common systemic manifestations of hypothyroidism include fatigue, dry skin, weight gain, hair loss, cold intolerance, hoarseness and constipation. Patients affected by this condition present a number of central and peripheral signs in the nervous system that may be neurological manifestations that occur along with the systemic disease. The conversion of thyroid hormone in the target tissue is done by three distinct deiodinases: type I, type II and type III. Each deiodinase has a different function in order to maintain thyroid hormone homeostasis in the tissues. Other proteins important for thyroid state are the TH transporters. MCT8, OATP1C1 and LAT1 and 2 transporters regulate T4 and T3 flow in the cells. The action of THs depends on the interaction of several proteins that are specialized in the control of thyroid hormone homeostasis not only in the brain but also in various tissues. THs are important for the maturation of the brain from the intrauterine period and remain important to adulthood. When there is some disturbance in the control mechanisms for the state of thyroid hormone, the consequences to the tissues, especially the CNS, can range from mild damage to severe impairment in neuronal development.