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Thyroid
peroxidase
Thyroglobulin
Sodium/iodide
cotransporter
Pendrin
Thyroglobulin
Thyroid
peroxidase
Methimazole
transporter
Thyroid
peroxidase
Thyroid
peroxidase
Thyroid
peroxidase
Iodotyrosine
deiodinase 1
Type I
iodothyronine
deiodinase
Unknown
Thyroglobulin
Thyroglobulin
Thyroglobulin
Thyroglobulin
Thyroglobulin
Thyroglobulin
Thyroglobulin
Thyroglobulin
Methimazole
Iodotyrosine
3,5-Diiodo-L-tyrosine
Thyroxine
Liothyronine
Iodide
Iodide
Na
+
Na
+
Iodide
Thyroxine
Liothyronine
Methimazole
H
2
O
2
H
+
Iodine
H
2
O
H
2
O
2
H
2
O
H
2
O
2
H
2
O
NADPH
L-Tyrosine
NADP
Iodide
NADPH
L-Tyrosine
NADP
Iodide
Carbimazole
Calcium
Heme
Calcium
Calcium
Calcium
FMN
FMN
Thyroxine
Liothyronine
Liothyronine
Thyroxine
Iodotyrosine
3,5-Diiodo-L-tyrosine
2-Aminoacrylic acid
2-Aminoacrylic acid
Amino acids
Thyroglobulin
proteolysis
Protein
Synthesis
Calcium
Heme
Heme
Heme
Heme
Exocytosis
Endocytosis
Endocytosis
Secretion
Secretion
Follicle lumen
Follicle cell
Plasma
Cytosol
Methimazole inhibits thyroid
peroxidase, preventing the
oxidation of iodide
The incorporation of iodine
into tyrosine molecules in
thyroglobulin is also
inhibited
The production of T3 and T4
is decreased
The concentration of T3 and
T4 secreted from the thyroid
follicle cell is decreased
Carbimazole is converted
into its active form,
methimazole, which is
transported into the thyroid
follicle cell
TPO
TG
SLC5A5
SLC26A4
TG
TPO
Unknown
TPO
TPO
TPO
DIO1
DIO1
Unknown
TG
TG
TG
TG
TG
TG
TG
TG
Methimazole
Iodotyrosine
3,5-Diiodo-L-
tyrosine
Thyroxine
Liothyronine
Iodide
Iodide
Sodium
Sodium
Iodide
Thyroxine
Liothyronine
Methimazole
Hydrogen
peroxide
Hydrogen Ion
Iodine
Water
Hydrogen
peroxide
Water
Hydrogen
peroxide
Water
NADPH
L-Tyrosine
NADP
Iodide
NADPH
L-Tyrosine
NADP
Iodide
Carbimazole
Thyroxine
Liothyronine
Liothyronine
Thyroxine
Iodotyrosine
3,5-Diiodo-L-
tyrosine
2-Aminoacrylic
acid
2-Aminoacrylic
acid
Amino acids
Thyroglobulin
proteolysis
Protein
Synthesis