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The glutamate residue is linked through its side-chain carboxyl, giving a gamma-glutamyl bond rather than a standard alpha-peptide bond, which is why the molecule resists most intracellular peptidases and is cleaved chiefly by gamma-glutamyl transpeptidase at the cell surface

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This personalized framework may reduce trial-and-error adjustments and improve confidence that levothyroxine dosing stays optimized as weight changes unfold

J Clin Med 8(5):756 Darras VM, Van Herck SL, Heijlen M, De Groef B (2011) Thyroid hormone receptors in two model species for vertebrate embryonic development: chicken and zebrafish