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Pituitary resistance to thyroid hormones: pathophysiology and therapeutic options

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Abstract

Thyroid hormone secretion suppresses the expression of thyroid stimulating hormone (TSH), both of which are strictly controlled by a negative feedback loop between the hypothalamus-pituitary and thyroid. Pituitary resistance to thyroid hormone (PRTH) is defined as resistance to the action of thyroid hormone that is more severe in the pituitary than at the peripheral tissue level. Although the molecular basis of PRTH is not well understood, the clinical issue mainly involves imbalance between the hypothalamus-pituitary and peripheral thyroid hormone responsivity, which may induce peripheral thyrotoxic phenomena. Here, we review the pathogenesis and molecular aspects of PRTH, present a single case with inappropriate TSH secretion suffering from thyrotoxicosis treated with PTU, and discuss the possible choice of therapeutic options to correct the imbalance of thyroid hormone responsivity in both the hypothalamus–pituitary and peripheral tissues.

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The authors declare that there are no conflicts of interest that could be perceived as prejudicing the impartiality of the research reported.

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Authors and Affiliations

  1. Department of Aging Medicine and Geriatrics, Institute on Aging and Adaptation, Shinshu University, Graduate School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan

    Satoru Suzuki, Satoshi Shigematsu, Hidefumi Inaba, Masahiro Takei, Teiji Takeda & Mitsuhisa Komatsu

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  1. Satoru Suzuki
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  2. Satoshi Shigematsu
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  3. Hidefumi Inaba
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  4. Masahiro Takei
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Correspondence to Satoru Suzuki.

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Suzuki, S., Shigematsu, S., Inaba, H. et al. Pituitary resistance to thyroid hormones: pathophysiology and therapeutic options. Endocrine 40, 366–371 (2011). https://doi.org/10.1007/s12020-011-9538-2

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