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Treating thyroid disorders involves a fascinating and troublesome delay, in which it takes many weeks for serum thyroid\u2010stimulating hormone (TSH) concentration to normalize after thyroid hormones return to normal. This delay challenges attempts to stabilize thyroid hormones in millions of patients. Despite its importance, the physiological mechanism for the delay is unclear. Here, we present data on hormone delays from Israeli medical records spanning 46 million life\u2010years and develop a mathematical model for dynamic compensation in the thyroid axis, which explains the delays. The delays are due to a feedback mechanism in which peripheral thyroid hormones and TSH control the growth of the thyroid and pituitary glands; enlarged or atrophied glands take many weeks to recover upon treatment due to the slow turnover of the tissues. The model explains why thyroid disorders such as Hashimoto's thyroiditis and Graves' disease have both subclinical and clinical states and explains the complex inverse relation between TSH and thyroid hormones. The present model may guide approaches to dynamically adjust the treatment of thyroid disorders.<\/jats:p>","DOI":"10.15252\/msb.202210919","type":"journal-article","created":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T03:45:17Z","timestamp":1659930317000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Dynamics of thyroid diseases and thyroid\u2010axis gland masses"],"prefix":"10.1038","volume":"18","author":[{"given":"Yael","family":"Korem Kohanim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4493-7244","authenticated-orcid":false,"given":"Tomer","family":"Milo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moriya","family":"Raz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer","family":"Karin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alon","family":"Bar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4479-3423","authenticated-orcid":false,"given":"Avi","family":"Mayo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Netta","family":"Mendelson Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9360-8987","authenticated-orcid":false,"given":"Yoel","family":"Toledano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1121-5907","authenticated-orcid":false,"given":"Uri","family":"Alon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,8]]},"reference":[{"key":"BFMSB202210919_CR1","first-page":"188","volume":"32","author":"M Ahmed","year":"1989","unstructured":"Ahmed M, Banna M, Sakati N, Woodhouse N (1989) Pituitary gland enlargement in primary hypothyroidism: a report of 5 cases with follow\u2010up data. 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