Exp Clin Endocrinol Diabetes 2020; 128(06/07): 473-478
DOI: 10.1055/a-1012-8484

Unraveling the Molecular Basis for Successful Thyroid Hormone Replacement Therapy: The Need for New Thyroid Tissue- and Pathway-Specific Biomarkers

Sebastian Nock
1   Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
Carolin Höfig
2   Institute for Experimental Endocrinology, Charité -Universitaetsmedizin Berlin, Berlin, Germany
Lisbeth Harder
1   Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
Lutz Schomburg
2   Institute for Experimental Endocrinology, Charité -Universitaetsmedizin Berlin, Berlin, Germany
Georg Brabant
1   Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
Jens Mittag
1   Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
› Author Affiliations


Thyroid function is conventionally assessed by measurement of thyroid-stimulating hormone (TSH) and free circulating thyroid hormones, which is in most cases sufficient for correct diagnosis and monitoring of treatment efficiency. However, several conditions exist, in which these parameters may be insufficient or even misleading. For instance, both, a TSH-secreting pituitary adenoma and a mutation of thyroid hormone receptor β present with high levels of TSH and circulating hormones, but the optimal treatment is substantially different. Likewise, changes in thyroid hormone receptor α signaling are not captured by routine assessment of thyroid status, as serum parameters are usually inconspicuous. Therefore, new biomarkers are urgently needed to improve the diagnostic management and monitor treatment efficiency for e. g., replacement therapy in hypothyroidism or thyroid hormone resistance. By comparing animal models to human data, the present minireview summarizes the status of this search for new tissue- and pathway-specific biomarkers of thyroid hormone action.

Publication History

Received: 08 August 2019
Received: 09 September 2019

Accepted: 12 September 2019

Article published online:
07 October 2019

© Georg Thieme Verlag KG
Stuttgart · New York

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