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Fig. 3 | Clinical Diabetes and Endocrinology

Fig. 3

From: A clinician’s guide to understanding resistance to thyroid hormone due to receptor mutations in the TRα and TRβ isoforms

Fig. 3

Models for RTHβ and RTHα. a RTHβ occurs in tissues expressing TRβ and causes a rise in serum T3 and T4 levels due to impaired negative feedback of the hypothalamic/pituitary/thyroid axis. b RTHα occurs in tissues expressing predominantly TRα (bone, gut, and heart) and causes symptoms shown in Table 1. In contrast to RTHβ, there is no defect in the negative feedback of the HPT axis by TH. However, patients have increased serum T4/ T3 ratios suggesting that a downstream effect such as increased deiodinase 1 (Dio 1) activity may occur

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