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This disease can be congenital, due to mutations in proteins that are essential for thyroid hormones synthesis pathway and defects in thyroid gland formation, or even the absence of the gland

Collectively, these effects lead to a decrease in the synthesis and secretion of TH by the thyroid gland.Yet, most of the circulating T 3 is not produced by the gland itself but through deiodination of T 4 in peripheral tissues, such as liver, kidney and muscle (83, 84)