Biological target · Receptor

Thyroid hormone receptor

Also known as: TR, THRA, THRB, nuclear thyroid receptor

The nuclear receptor in nearly every cell through which triiodothyronine (T3) sets the pace of metabolism, heart rate, temperature and growth. Levothyroxine replaces the thyroid's output and acts on it after conversion to T3.

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Kind
receptor
Also called
TR, THRA, THRB, nuclear thyroid receptor
Where it is found
Nuclei of cells in virtually all tissues, with distinct receptor subtypes dominant in heart, brain, liver and pituitary.

What it does

The thyroid secretes mostly thyroxine (T4), which tissues convert to the active hormone T3 with deiodinase enzymes; T3 enters the nucleus and binds thyroid hormone receptors that switch genes on or off. In the heart the result is a faster rate and stronger contraction, in metabolism a higher resting energy expenditure and heat production, in the liver lower cholesterol, in bone higher turnover, and in the developing brain normal maturation, which is why newborns are screened for hypothyroidism. Levothyroxine is synthetic T4: taken once daily on an empty stomach it is converted to T3 as the body requires, giving steady levels with a half-life of about a week. Dosing is judged by the TSH, which the pituitary lowers as replacement becomes adequate. Too much replacement drives the same receptors excessively and causes palpitations, atrial fibrillation, weight loss, anxiety and bone loss; too little leaves the tiredness, weight gain, cold intolerance and slowed heart of hypothyroidism. Iron, calcium, antacids and proton pump inhibitors cut absorption of the tablet.

Role in the body

Transcriptional control of metabolic rate, cardiac output, thermogenesis, lipid metabolism, growth and neurodevelopment.

Medicines that act on it

Drug classes

Conditions it is involved in

Educational content. Describes what a receptor, enzyme, channel or pathway does and which medicines act on it. Educational, not prescribing advice.