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reverse triiodothyronine isomer tetraiodothyronine thyroid gland iodine t3 t4 hypothalamus pituitary hormone neurotransmitter euthyroid sick syndrome thyroxine 5-deiodinase synthesis biologically inactive conversion brain development rendering hormonal therapy replacement function action endocrine endocrinology level prohormone analogue thyroid deiodinase hypothyroidism hyperthyroidism thyromimetic thermogenesis molecule molecular formula skeletal structural structure geometry ball stick atom bioactive cell