Physiological states and functional relation between thyrotropin and free thyroxine in thyroid health and disease: in vivo and in silico data suggest a hierarchical model

  • John E M Midgley, Rudolf Hoermann, Rolf Larisch, Johannes W Dietrich
  • Journal of Clinical Pathology, February 2013, BMJ
  • DOI: 10.1136/jclinpath-2012-201213

Thyroid homeostasis results from multi-loop control

What is it about?

Theoretical considerations and animal experiments question the validity of the logarithmic standard model of thyroid homeostasis. Exact physiological relations are unknown in humans, however. This trial investigated the relation between free T4 and log TSH in a large cohort of 6641 subjects. In hypothyroid persons the correlation slope was different from that in euthyroid and hyperthyroid subjects. These results and sensitivity analysis obtained from SimThyr suggest a hierarchical control mode.

Why is it important?

Both in vivo data from a large cohort of more than 6000 subjects and in silico results from computer simulations with SimThyr suggest thyroid homeostasis to result from interaction of multiple control loops. These findings warrant future physiological research. Furthermore they question a TSH-only strategy in diagnostic evaluation of thyroid homeostasis.

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The following have contributed to this page: PD Dr. med. Johannes W Dietrich and Professor Rudolf Hoermann