Once upon a time,
The pituitary gland
was married to the thyroid gland.
Ms. Thyroid started neglecting her husband.
She had already had many children,
T4 and T3 hormones,
But apparently not enough for him.
Mr. P used to scream at her
with insistent TSH shouts
“produce more children NOW! I mean yesterday!
Tsh, Tsh, lazy wife!”
But she couldn’t help it. It wasn’t her fault.
Antibodies were attacking her at work,
getting her all inflamed and stressing her out.
She got sick and tired of being pregnant
and being screamed at with “Tsh, Tsh” at home.
She gave up and got a divorce.
Then came along a sexy new replacement,
Foxy Ms. Levothyroxine.
She was actually a robot,
but he couldn’t tell the difference.
Levo was made by the people in a nearby town
who were shocked by the many offensive TSH words
they kept reading in their newspapers.
They just wanted to keep him quiet and calm
so that his town could be at peace.
Foxy Levo charmed Mr. Pituitary
with her productivity.
Just look at all her T4 children!
(the preferred sex, T4).
Hubby pituitary doesn’t yell as much anymore.
He’s now conversing in TSH
with a robotic hormone pill.
The pituitary and his dearly beloved pill
talk TSH pleasantly now,
in a very “normal” way (so they say)
And that pleases the robot pill’s makers
Unbenowknst to the husband,
the robot-wife is controlled by her makers
and they hold the reins.
Levo’s size determines
how much he can say,
and if he goes out of bounds,
her makers press a button that
makes Ms. Levo bigger.
It’s so simple.
When she’s bigger, he gets intimidated
and doesn’t say as much.
And when he’s too quiet,
they make her smaller
to coax him to talk.
They always need to know
they’re still in control,
for the dire prophets say
monsters will come
if he stops talking.
Mr. Pituitary doesn’t realize
that Robot Levo produces her own children
and doesn’t really need
his “Tsh, Tsh” reminder.
The robot’s T4 children are growing up now
and they are having T3 children of their own.
But strangely enough,
they aren’t having as many T3 children
as Ms. Thyroid did in her youth.
T4 is Levo’s preferred sex, after all,
even though T3 always works ten times as hard
and used to run the whole town.
Mr. Pituitary sends mild and fatherly
“Tsh, Tsh” emails
to his T4 children
who live in the suburbs of bones and brain
advising them to make some T3
for their own homes
if they are ever in need.
The T4s become so abundant
they start giving birth
to lazy, backward “Reverse T3” kids instead.
But that’s okay with Mr. Pituitary,
more T4 comes every day from Ms. Levo
to replace those
inactive couch potatoes.
Some of the T3 hormone gets converted into T2,
But Daddy Pituitary does not seem to care
that his town is running low on
T3 retail workers
and T3 snowplow drivers.
As long as he has enough T3
serving him pizza and donuts
in his own home
the rest of the town can take care of itself.
So he will lovingly coo “Tsh, Tsh”
in a well-regulated and normalized way
at his robot-pill and his T4 brood
and bask in his T4-dominant community
with T3 kneeling at his table,
while out there, T3 gets depleted
and nobody’s picking up the garbage
or putting out fires.
You’d think the neighboring town’s robot-makers
would notice that this is going on,
since they (theoretically)
care about that town, too.
They do check on Mr. Pituitary now and then.
They call it the “Thyroid function test” annual newsletter
even though they know Ms. Thyroid is long gone
and Mr. Pituitary’s words are regulated
And as long as they have their own children and servants,
And Mr. Pituitary keeps talking nice,
They believe there must be
enough T4 and T3
Oh, and the garbage in the streets?
The streetlights burning out?
“Their town’s just getting too lazy,” they say.
“It’s always been underactive.”
You are welcomed to write
your own additions or amendments to this tale
such as a Graves’ disease version, a thyroid cancer version
and add to other aspects of our sad story
like the many symptoms.
Read more about the disconnect
between the TSH hormone and our the T3 hormone
in hypothyroid patients on therapy.
See Rationale: Reference ranges under “Altered HPT axis”