Pituitary and Thyroid Physiology · Physiology

Reverse T3 (rT3) is typically elevated in patients with 'Sick Euthyroid Syndrome.' How is rT3 produced?

  1. Directly from the thyroid gland colloid
  2. By deiodination of T4 at the 5-position (inner ring)
  3. By deiodination of T3 at the 5'-position (outer ring)
  4. By the coupling of two MIT molecules
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Correct answer: By deiodination of T4 at the 5-position (inner ring)

rT3 is formed when T4 is deiodinated at the inner ring (5-position) rather than the outer ring. In states of severe illness or starvation, the body shunts T4 metabolism toward the inactive rT3 to conserve energy.

Difficulty: Medium Question 30 of 40

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