Hypothalamic–pituitary–thyroid axis Hypothalamic–pituitary–thyroid axis The hypothalamic–pituitary–thyroid axis (HPT axis for short, a.k.a. thyroid homeostasis or thyrotropic feedback control) is part of the neuroendocrine system responsible for the regulation of metabolism. As its name suggests, it depends upon the hypothalamus, the pituitary gland, and the thyroid gland. The hypothalamus senses low circulating levels of thyroid hormone (Triiodothyronine (T3) and Thyroxine (T4)) and responds by releasing thyrotropin-releasing hormone (TRH). The TRH stimulates the anterior pituitary to produce thyroid-stimulating hormone (TSH). The TSH, in turn, stimulates the thyroid to produce thyroid hormone until levels in the blood return to normal. Thyroid hormone exerts negative feedback
Pituitary pars intermedia dysfunction by corticotropes in the pars distalis of the equine pituitary. In a normal horse, this accounts for the majority of ACTH production. ACTH produced by the pars distalis is subject to negative feedback in a normal horse, so high cortisol levels reduce ACTH production by the pituitary, subsequently reducing cortisol levels. In a horse with PPID, ACTH levels are high as a result of pars intermedia production, but it is not subject to negative feedback regulation. Despite the high levels of ACTH, cortisol levels vary, and are sometimes lower than normal. Additionally, hyperplasia of the adrenal cortex is infrequent. The