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Spagnoli A, et al

10.1074/jbc.RA120.016019 58 RadziejewskaA.ChmurzynskaA

Mechanistically, HPE enhanced insulin signaling by increasing the phosphorylation levels of insulin receptor substrate 1 (IRS1), phosphoinositide 3-kinase (PI3K), protein kinase B (AKT), and glucose transporter type 4 (GLUT4) in the liver, thereby activating the IRS1PI3KAKTGLUT4 pathway and improving insulin resistance

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When circulating T 4 levels decrease, the pituitary gland increases its secretion of TSH, resulting in increased iodine trapping, as well as increased production and release of both T 3 and T 4