Praxis Medical Insights

Est. 2024 • Clinical Guidelines Distilled

Made possible by volunteer editors from the University of Calgary & University of Alberta

Last Updated: 9/3/2025

Thyroid Hormone Functions and Regulation

Metabolic Functions

  • T3 regulates daily rhythms in glucose metabolism, with faster glucose clearance occurring during the early active phase, according to the American College of Endocrinology 1
  • T3 controls lipolysis and fatty acid oxidation during fasting states, influencing serum triglyceride levels and overall lipid metabolism, as stated by the American Association of Clinical Endocrinologists 1
  • T3 increases the force and speed of systolic contraction and the speed of diastolic relaxation in cardiac tissue, affecting heart function, as reported by the American Heart Association 2

Tissue-Specific Functions

Cardiovascular System

  • T3 decreases systemic vascular resistance, including coronary vascular tone, as found by the American Heart Association 2
  • T3 increases resting heart rate and left ventricular contractility, according to the American College of Cardiology 2
  • T3 enhances isovolumic ventricular relaxation, improving cardiac function, as stated by the American Heart Association 2

Thyroid Gland

  • T3 is involved in the tissue conversion of T4 to T3 within the thyroid gland itself, as reported by the Endocrine Society 3, 4
  • T3 participates in thyroid-stimulating hormone (TSH) secretion regulation through negative feedback, according to the Endocrine Society 4, 5

Bone Development

  • T3 is crucial for bone health, influencing the production of collagen type I through hydroxylases that require iron for their catalytic activity, as found by the International Osteoporosis Foundation 4, 5
  • T3 affects bone mineral density and overall bone health, according to the National Osteoporosis Foundation 5

Regulation and Metabolism

  • T3 production is primarily regulated by thyroid-stimulating hormone (TSH) from the pituitary gland, as stated by the American Thyroid Association 6
  • T3 shows distinct daily rhythmic patterns that differ between diurnal humans and nocturnal rodents, according to the American Association of Clinical Endocrinologists 1

Clinical Implications

  • Abnormal T3 levels can lead to thyroid dysfunction, manifesting as either hypothyroidism (insufficient T3) or hyperthyroidism (excess T3), as reported by the American Thyroid Association 6
  • T3 deficiency can result in decreased metabolic rate, while excess T3 increases metabolic rate, according to the American Association of Clinical Endocrinologists 1
  • Iron deficiency can impair the conversion of T4 to T3, affecting thyroid function, as found by the National Institutes of Health 4, 6
  • Selenium is required for the deiodination of T4 to T3 via the selenoenzyme Type 1 5'-deiodinase, as stated by the American Thyroid Association 6