1. How do medication, other physiological conditions like pregnancy, and pathological conditions like acute hepatitis and chronic liver disease affect thyroid hormone metabolism and the requirement of levothyroxine if the patient is already on thyroid supplements? There are some proteins in blood like thyroxine-binding globulin (TBG) that transport levothyroxine (T3, T4) In blood to peripheral tissue. pregnancy, acute hepatitis, oral contraceptive pills containing estrogen, and medications like tamoxifen, and raloxifene increase TBG. When TBG rises in the blood, TBG binds to free T3 and free T4 increasing the total T3, and T4 in the blood and decreasing the concentration of free T3, and free T4. Peripheral tissue senses the low level of free T3, and free T4, thus it stimulates the pituitary gland to produce more TSH. TSH in turn stimulates the thyroid gland to produce free T3 and free T4. 2. what are conditions where TBG decreases? a. chronic liver disease b. drugs like androgenic horm...
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