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When produced excessively, it may suppress the release of Thyroid Stimulating Hormone from the pituitary. 18 It also forces T4 to be converted to reverse T3 (rT3) which actually blocks thyroid function, even though thyroxine levels look adequate when tested. 19 Blood glucose imbalance also triggers cortisol secretion, and insulin resistance may have a direct negative effect on the thyroid, too

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179 Inhibition of TGF-1 signalling may also be a useful therapeutic strategy in COPD

The most critical of these is a compound known as M1 ( 5-(3',4'-dihydroxyphenyl)--valerolactone )