FT4
How hypothyroid can it be
I would like to know how hypothyroid the model can get when the different parameters from fig. 6. A in Principles, Hoermann et al 2022.
Recap text from fig. 6. A: FT4 levels (blue curve) decline, but the mechanisms in system (sys. 10) protect FT3 levels (green curve), keeping them in a range close to the original level, as the percentage of the estimate of FT4 production rate constant (k32 = 0.4 to 1.1) decreases – as typical at the onset of hypothyroidism in patients suffering from autoimmune thyroiditis and progressive thyroid destruction. Other parameters are chosen within ranges, k423 = 0.2-0.3, k43 = 0.7-0.8 and k42 = 0.1-0.2, to approximate the relative contributions to FT3 production according to (32).
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The figures shows the most hypothyroid state the model can achieve under the given conditions.
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Trying to change the k42 parameter which results in a slight decrease of TSH
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Adding drug4 = 0.8 to the most hypothyroid state. We see FT3 is not returning to the level in the perfect homeostasis. See sys1 below. Apart from that FT3 drops with lower k32.
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Here I have tried to show the pattern following perfect homeostasis plus drug4. Mimicing the situation where a patient gets unnecessary LT-4 treatment. Will it be possible to identify the pattern and use it to get the patient off LT-4? Is the pattern disguised by the transformation to real hormone values?
Scenarios – observations 1
Pilo (1) and Kobuta (2) are different scenarios and here we have looked into TSH, FT3 and FT4 from the Simthyr model.
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Below you find the description of the Pilo scenarios (The Kubota scenarios will follow later in the text) – The last entry is the figures for the standard scenario in SimThyr:
Case No. 1 from Pilo et al. showing slight hyperdeiodination and high conversion rate The FT3 value is 6,97 a little higher than the standard value (5,36) The FT4 value is lower than the standard value (17,76) – Pilo 1 (13,72) The TSH value is 1,36 and the standard value is 1,96 Pilo 1 GH < (lower than) standard. See the effect of GH here Pilo 1 LS > (higher than) standard. See the effect of LS here Pilo 1 SS > standard. See the effect of SS here Pilo 1 GT < standard. See the effect of GT here Pilo 1 GD1 > standard. See the effect of GD1 here (Diagram) |
Case No. 2 from Pilo et al. showing slight hyperdeiodination The FT3 value is 9,13 a little higher than the standard value (5,36) The FT4 value is lower than the standard value (17,76) – Pilo 2 (14,08) The TSH value is 1,57 and the standard value is 1,96 Pilo 2 LS > standard. See the effect of LS here Pilo 2 GT < standard. See the effect of GT here Pilo 2 GD1 > standard. See the effect of GD1 here (Diagram) |
Case No. 6 from Pilo et al. with low secretion rate for T4 The FT3 value is 5,46 a little higher than the standard value (5,36) The FT4 value is lower than the standard value (17,76) – Pilo 6 (11,84) The TSH value is 1,70 and the standard value is 1,96 Pilo 6 LS > (higher than) standard. See the effect of LS here Pilo 6 SS > standard. See the effect of SS here Pilo 6 GT < standard. See the effect of GT here Pilo 6 GD1 > standard. See the effect of GD1 here (Diagram) |
Case No. 11 from Pilo et al. with high secretion rate for T4 The FT3 value is 6,11 a little higher than the standard value (5,36) The FT4 value is lower than the standard value (17,76) – Pilo 11 (11,84) The TSH value is 1,23 and the standard value is 1,96 Pilo 11 GH < standard. See the effect of GH here Pilo 11 dH < standard. See the effect of GH here Pilo 11 LS > standard. See the effect of LS here Pilo 11 SS > standard. See the effect of SS here Pilo 11 GT < standard. See the effect of GT here Pilo 11 GD1 > standard. See the effect of GD1 here (Diagram) |
Case No. 12 from Pilo et al. with high production rate for T3 The FT3 value is 6,64 a little higher than the standard value (5,36) The FT4 value is lower than the standard value (17,76) – Pilo 12 (14,1) The TSH value is 1,47 and the standard value is 1,96 Pilo 12 GH < standard. See the effect of GH here Pilo 12 LS > standard. See the effect of LS here Pilo 12 SS > standard. See the effect of SS here Pilo 12 GT < standard. See the effect of GT here Pilo 12 GD1 > standard. See the effect of GD1 here (Diagram) |
Case No. 14 from Pilo et al. with low production rate for T3 Coming soon |
Case No. 10 from Pilo et al. with normal values for SPINA-GT and SPINA-GD |
Case No. 1 from Kubota et al. showing latent (subclinical) hypothyroidism |
Case No. 2 from Kubota et al. showing overt hypothyroidism |
Case No. 5 from Kubota et al. showing overt hypothyroidism |
Look hypophyseal secretory capacity (GH) up – LINK
- Pilo A, Iervasi G, Vitek F, Ferdeghini M, Cazzuola F, Bianchi R. Thyroidal and peripheral production of 3,5,3′-triiodothyronine in humans by multicompartmental analysis. Am J Physiol. 1990 Apr;258(4 Pt 1):E715-26. PubMed PMID: 2333963.
- Kubota S, Fujiwara M, Hagiwara H, Tsujimoto N, Takata K, Kudo T, Nishihara E, Ito M, Amino N, Miyauchi A. Multiple thyroid cysts may be a cause of hypothyroidism in patients with relatively high iodine intake. Thyroid. 2010 Feb;20(2):205-8. doi: 10.1089/t
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