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It is built on a 37-residue modified human amylin / pramlintide-style backbone with three rationally designed substitutions (N14E and V17R to stabilise the central alpha-helix through a salt bridge, P37Y to enhance calcitonin-receptor potency) and N-terminal acylation with a C20 eicosanedioic fatty diacid attached via a gamma-glutamic acid linker
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and an enlarged damaged gland containing giant cells
This imbalance occurs because the body senses too much thyroid hormone in the bloodstream, signaling the pituitary gland to reduce TSH release in an attempt to restore hormonal balance
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