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After crossing the blood-brain barrier,T4 andT3are transferred into neighboring astrocytes, whereT4 isconverted toT3.Note thatT3isthe predominate hormone that enters the neurons.T4andT3 arealso secreted into the cerebrospinal fluid and are taken up by the tanycytes (specialized ependymal cells) and astrocytes, where T4is converted toT3.In addition toTRH, which also stimulates production of prolactin in lactotropes, the hypothalamus secretes somatostatin that has an inhibitory effecton TSH production by thyrotropes. Urgent surgery within the next day is the most appropriate managementin a patient with asymptomatic abdominal aortic aneurysm. Postoperatively (500 mg daily): though vit Cdoes not enhance normal healing, suboptimalhealing can be guarded against.
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