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 THE BSY GROUP

NUTRITION COURSE – THE SCIENTIFIC APPROACH

LESSON TWO
 THE BSY GROUP

Founded 1946

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 THE BSY GROUP

NUTRITION COURSE –THE SCIENTIFIC APPROACH

LESSON TWO

LEARNING OUTCOMES

On completing the study of this lesson you should be able to:

1) Give an overview of the organs and functions of the endocrine system

2) Summarise the two main types of thyroid disorders and their signs and symptoms

3) Relate dietary factors and nutritional intake to the function of the thyroid gland
 THE BSY GROUP

NUTRITION COURSE – THE SCIENTIFIC APPROACH

LESSON TWO

THE ENDOCRINE SYSTEM

Hormones
Hormones are the essential part of the body that controls and balances the body functions.
As we have seen in the genetic variation and the nutrigenomics in Lesson One, the type of
food intake can variably affect the hormones in the body and therefore balance or
unbalance the body systems. A deficiency or an excess of certain nutrients could also
affect the secretion of hormones and therefore cause a body imbalance with consequences
for the health.

There are two types of glands, the exocrine and the endocrine glands. Endocrine glands
constitute the endocrine system.

The exocrine glands include sudoriferous, sebaceous, mucous and digestive glands.
These glands secrete their products into ducts, and the ducts transport the secretions into
body cavities, into the lumens of various organs or to the body’s surface.

The endocrine glands secrete their hormones into the extracellular space around
secretory cells instead of into ducts. Hormones then pass into the capillaries, which are
then transported in the blood. The endocrine glands are the pituitary, thyroid,
parathyroid, adrenals, pineal, hypothalamus and thymus. Some organs in the body also
have endocrine tissue. These organs are the pancreas, ovaries, testes, kidneys, stomach,
small intestine, skin, heart and placenta.
 Nutrition Course – The Scientific Approach: Lesson Two

Hormones consist of amines, proteins and peptides, and steroids.

 Amines are simple molecules, derived from the amino acid tyrosine. The thyroid
hormones are derived from this type of hormone, as well as noradrenaline and
adrenaline (catecholamines), which are secreted by the adrenal glands, and
dopamine, produced by the hypothalamus and in the brain. These hormones are
water-soluble and include histamine, serotonin and melatonin.

 Proteins and peptides are made up from a chain of amino acids, which vary in
size and are water-soluble. Oxytocin is one of these hormones and is secreted by
the hypothalamus and is a very large molecule, while insulin secreted by the
pancreas is a relatively small molecule. Other types of protein and peptide
hormones are secreted by the parathyroids, thyroid and anterior pituitary glands;
these groups are called glycoprotein hormones.

 Steroid hormones are derived from cholesterol (lipid soluble). Aldosterone,

cortisol and androgen hormones (oestrogen and progesterone) are examples of
steroid hormones. These hormones are secreted by the testes, ovaries and cortex
(outer zone) of the adrenal glands. Thyroid hormones such as triiodothyronine
(T3) and thyroxine (T4) are also lipid soluble hormones. Nitric oxide (NO) is both
a hormone and a neurotransmitter.

Hormones are released according to the body’s need. Their secretion is regulated by the
sensing and signalling system that allows them to be released and stopped when
necessary. Once they are released they are carried by the blood to their target cells, which
have specific receptors that respond to the specific hormones. Receptors are large
molecule proteins that respond only to the appropriate molecule. For example, the
thyroid stimulating hormones (TSH) will interact only with receptors that are found on
the surface cells of the thyroid gland. Once a specific hormone bonds to its receptor it
triggers an activation of a chain of biochemical events inside the target cells that will bring
about the physiological effects that the hormone is meant to cause.

The catecholamines, protein and peptide hormones are carried by the blood, while the
steroid hormones and thyroid hormones are transported by one or more plasma proteins

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 Nutrition Course – The Scientific Approach: Lesson Two

that are synthesised in the liver (albumins, globulins and fibrinogen). Steroids and
thyroid hormones alter cell function by activation of genes. Because they are lipid-
soluble, they enter the plasma membrane of the target cell easily, and from there they
enter the cell nucleus. The binding will cause the receptor to make a transformation and
interacts with specific genes of the nuclear DNA, which activates them to form proteins,
mainly enzymes, that are needed to produce the effect that is characteristic of that
hormone.

Hormone secretion is regulated by signals from the nervous system, chemical changes in
the blood and other hormones, and most hormones are regulated by negative feedback
control. The exceptions are the oxytocin (OT) and luteinising hormones (LH), which use a
positive feedback cycle. In the negative feedback control, the body’s response, increased
or decreased, is the opposite (negative). For example when the blood calcium level is too
low, the parathyroids release more parathyroid hormones (PTH). The PTH then has its
effects on various parts of the body until the blood calcium level is back to normal. The
control and balance of insulin, adrenaline and noradrenaline also use the negative
feedback system.

Oxytocin is released from the pituitary gland in response to nerve impulses from the
hypothalamus in a positive feedback cycle. The output intensifies the input of OT. In the
positive feedback cycle the increase of LH also results in ovulation in the menstrual cycle.

Major Glands and their Hormones

The pituitary gland is divided into posterior and anterior lobes. Both of them are closely
associated with the hypothalamus.

The hormones released by the anterior pituitary are:

 Human growth hormone (HGH): growth of body cells, protein anabolism,

elevation of blood glucose concentration
 Thyroid stimulating hormone (TSH): controls secretion of thyroid hormones by
thyroid gland
 Adreno-corticotropic hormone (ACTH): controls secretion of some hormones by
adrenal cortex (cortisol)

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 Nutrition Course – The Scientific Approach: Lesson Two

 Follicle-stimulating hormone (FSH): initiates development of ova and induces

ovarian secretion of oestrogens. In male, stimulates testes to produce sperm
 Luteinising hormone (LH): in female, together with FSH, stimulates ovulation and
formation of progesterone-producing corpus luteum. In male, stimulates
interstitial cells in testes to develop and produce testosterone
 Prolactin (PRL): in females, together with other hormones, initiates and maintains
effect of LH in promoting milk secretion by the mammary glands. In males,
enhances production of testosterone
 Melanocyte-stimulating hormone (MSH): stimulates dispersion of melanin
granules in melanocytes

The hormones released by the posterior pituitary are:

 Oxytocin (OT): stimulates contraction of smooth muscle cells of uterus during

labour and stimulates contraction of contractile cells of mammary glands for milk
ejection (hypothalamus gland)
 Antidiuretic hormone (ADH): principal effect is to decrease urine volume. Raises
blood pressure.

The posterior lobe is not an endocrine gland as it only stores and releases the two
above-named hormones (the hypothalamus gland secretes both hormones).

The adrenals are situated above each kidney. They have both an outer region, the adrenal
cortex, and an inner region, the adrenal medulla.

The adrenal cortex secretions are:

 Mineralcorticoids (mainly aldosterone), responsible for the absorption of sodium

 Glucocorticoids (cortisol, corticosterone and cortisone). These hormones work
together with other hormones to make sure that there is enough energy available.
They respond to the increased needs of energy during a range of stressful
situations, such as fright, high temperature, high altitude, bleeding, infections,
surgery, trauma, disease, and others
 Gonadocorticoids (oestrogen and androgens)

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 Nutrition Course – The Scientific Approach: Lesson Two

The adrenal medulla secretions are:

 Adrenaline: mimics the sympathetic division of the autonomic nervous system

during stress
 Noradrenaline: as above

The pancreas is an exocrine and endocrine gland. The exocrine function of the pancreas
works in the digestive system.

Hormone secretions are:

 Glucagon: raises blood sugar level by accelerating breakdown of glycogen into

glucose in liver (glycogenolysis) and conversion of other nutrients into glucose in
liver (gluconeogenesis) and releasing glucose into blood
 Insulin: lowers blood sugar level by accelerating transport of glucose into cells,
converting glucose into glycogen (glycogenesis) and decreasing glycogenolysis
and gluconeogenesis, increases lipogenesis and stimulates protein synthesis
 Growth hormone inhibiting hormone (GHIH): inhibits secretion of insulin and
glucagon

The ovaries are paired oval bodies located in the pelvic cavity. They produce the female
sex hormones, oestrogen and progesterone. These hormones are responsible for the
development and maintenance of female sexual characteristics. Also they regulate the
menstrual cycle, maintain pregnancy and prepare the mammary glands for lactation.

Inhibin is a hormone that is also produced by the ovaries to stop the secretion of follicle
stimulating hormone (FSH) and lutenising hormone (LH) especially at the end of the
menstrual cycle. Relaxin is a hormone that relaxes the synphysis pubis and helps dilate
the uterine cervix near the end of pregnancy.

The testes are also two oval glands positioned at the top of the scrotum. The testes
produce testosterone, which is the main male sex hormone. Testosterone is responsible
for the male characteristics. Testes also produce inhibin which stops the secretion of FSH
in males.

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 Nutrition Course – The Scientific Approach: Lesson Two

The pineal gland starts to accumulate calcium (acervulus or ‘brain sand’) from the age of
puberty.

Hormone secretions are:

 Melatonin: produced during darkness. Light reaching the eyes will stop its
production. Melatonin inhibits reproductive activities by inhibiting gonadotropic
hormones, as well as inducing sleep in children and adults
 Adrenoglomerulotropin: may stimulate the adrenal cortex to secrete aldosterone

The hypothalamus is located below the thalamus. This gland has many functions. The
main one is to maintain the body’s homeostasis. Homeostasis is a condition in which the
body’s internal environment remains within certain physiological limits (homeo = same;
stasis = standing still). An organism is said to be in homeostasis when its internal
environment contains the optimum concentration of gases, nutrients, ions and water, has
an optimal temperature and an optimal pressure for the health of the cell. Therefore the
hypothalamus has all and many more of the functions described below:

It controls and integrates the autonomic nervous system, receives sensory impulses from
viscera, regulates and controls the pituitary gland. It is the centre for mind-over-body
phenomena, secretes regulating hormones (e.g. OT and ADH), functions in rage and
aggression. It controls normal body temperature, food intake (satiety) and thirst, helps
maintain the waking state and sleep.

The thymus gland is involved in the lymphatic system and the immune system.
Hormones secreted by the thymus gland called thymosin, thymic, humural factor (THF),
thymic factor (TF) and thymopoietin, all promote proliferation and maturation of T cells
(immune system cells that mature in the thymus, therefore called T cells).

The thyroid gland is located below the larynx. The thyroid gland secretes thyroid
hormones and, as for the pituitary gland hormones, the thyroid hormones respond to the
stimulation of the hypothalamus which in turn responds to the body’s environmental
condition.

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 Nutrition Course – The Scientific Approach: Lesson Two

Hormone secretions are:

 Thyroxine (T4): regulates organic metabolism, growth and development, as well as

activity of nervous system
 Triiodothyronine (T3): same as above
 Calcitonin (CT): lowers blood levels of calcium by accelerating calcium absorption
in bones

The parathyroid is behind the thyroid gland. There are two parathyroid glands attached
to the superior and inferior side of each thyroid lobe. The glands secrete parathyroid
hormone (PTH), which controls the homeostasis of the ions in the blood, especially
calcium and phosphate ions. If enough vitamin D is present, PTH increases the
absorption from the gastrointestinal tract into the blood of calcium, phosphate and some
magnesium. The PTH also leads to the activation of vitamin D. If there is a deficiency of
vitamin D, there will be a decrease of ionised calcium absorption from the intestinal tract,
which will lead to an increased secretion of PTH. Elevated PTH will lead to an increase of
osteoclastic activity (resorption – calcium is taken out of the bones), which will cause
osteoporosis and an increase in the risk of fracture.

Magnesium is also an important mineral for the balance and control of PTH secretion.
Elevated magnesium will lead to a shut-down of the PTH production, while low
magnesium will lead to an excessive decrease of the PTH secretion which prevents the
PTH from acting on the skeleton.

Disorders of the parathyroid gland are:

 Hypoparathyroidism – results in tetany

 Hyperparathyroidism – produces osteitis fibrosa cystica

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 Nutrition Course – The Scientific Approach: Lesson Two

Thyroid Functions and Disorders

In order for the T4 to work, it has to be converted into T3. The conversion happens in the
liver, kidney, brain and other body tissues, as well as the pituitary gland. T3 on the other
hand, made by the thyroid gland, can be used immediately. The thyroid hormones are
significant for:

 Mental composure and alertness

 Growth
 Blood fat balance
 Strong and steady heart function and blood circulation
 Balancing the appetite, bowel function and body weight
 Fluid balance in the body
 Muscle strength
 Ability to fight infections

During adult years an underactive thyroid (hypothyroidism) can lead to myxoedema.

During growth years it can result in cretinism.

Symptoms of hypothyroidism include:

 Fatigue, weakness of muscles and stiff joints

 Feeling cold, particularly in hands and feet (body temperature stays down to 36.5
or less)
 Inappropriate weight gain, or difficulty in losing weight, despite proper diet and
exercise
 Loss of hair, coarse hair
 Brittle nails that split and break easily
 Cracked skin on heels
 Dry skin, coarse skin
 Thick tongue
 Swollen face and swollen neck
 Constipation
 Decreased sweating
 Pale lips

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 Nutrition Course – The Scientific Approach: Lesson Two

 Shortness of breath, chest pain

 Loss of appetite
 Hoarse voice
 Depression
 Numbness and tingling of hands and feet
 Heavy periods, infertility, lack of libido for both sexes
 Palpitations
 Deafness
 Swollen eyelids
 Slow speech
 High cholesterol levels
 Chronic yeast infections, oral fungus thrush
 Stomach and abdominal bloating
 Recurrent infections

Causes of hypothyroidism include:

 Autoimmune thyroiditis (Hashimoto’s disease) about 70% of the cases

 History of treatment for thyrotoxicosis (20%) (production of excess thyroxine by
the thyroid)
 Iodine deficiency
 Intake of certain drugs (lithium, amiodarone)
 Pituitary damage
 Thyroid tissue resistance (inability to use the thyroid hormones)
 Congenital, absent or abnormal thyroid
 Inability to make normal thyroid hormones

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Blood tests can be used to assess thyroid gland function. Each laboratory has its own test
range, which means that the results can be different according to the laboratory and the
method used. The following is an example of one test range:

Free T4 9-28 picomols/l

Free T3 3-8 picomols/l

Total T4 60-155 nanomols/l

Total T3 1-3 nanomols/l
TSH 0.3-5.0 milliunits/l

As T4 and T3 fall, the pituitary gland releases TSH to encourage increased hormone
production in the thyroid glands (TSH blood test results will be raised). Total T4 and T3,
used by some laboratories measure the protein carrier level as well. With the total T4 and
T3 test though, other factors needs to be accounted for and can affect the test results. For
example, for women who are pregnant, on hormone replacement therapy, on the
contraceptive pill, or using other medication, the total T4 and T3 can be raised and
therefore mask the underlying thyroid problem. In this case, though, the TSH
measurement will not be affected, and therefore any possible thyroid problem should be
addressed.

Other laboratory tests that can give an indication of a thyroid problem if found abnormal
are: blood tests for anaemia, high cholesterol electrolyte concentrations, glucose
(diabetes), and heart problems (slow pulse and other irregularities). Blood tests at times
might be normal even though some of the above signs are in place and they might be
normal for quite some time until the thyroid cannot cope any more and then medical
intervention has to take place.

According to Durrant-Peatfield, blood tests are not to be considered the only tests to
diagnose hypothyroidism. Symptoms and urine tests can be more appropriate at times.
A thyroid urine test checks for the hormones actually used by the tissue and therefore
shows the tissue levels of thyroid. Also there is a blood test that measures any antibodies
against the thyroid cells which would cause a destruction of the gland (Hashimoto’s
disease).

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 Nutrition Course – The Scientific Approach: Lesson Two

Dr Barnes basal temperature test is very easy to do and it can be a good indication of the
thyroid working below optimal level. Immediately on waking (do not get up) measure
your (mouth) temperature for three minutes with an ordinary glass thermometer (less
with an electric one), two to three seconds with an ear thermometer or ten minutes with a
normal mercury armpit thermometer. The measurements should be taken for a month
and the average results should be taken, as the temperature could vary from day to day.
You also need to be free of infections. If the basal temperature is below 36.5C there is a
low-functioning thyroid system, while an average reading of 36.5C and 36.8C is normal.

When considering a treatment for thyroid disorders the adrenal gland needs to be
considered also. In case of constant stress, the adrenals can become exhausted. If the
adrenal reserves are low, the conversion of T4 to T3 is not good, which leads to an
increase of circulating T4. Also with the adrenal insufficiency the receptors become
dormant, and T3 cannot be used by the body when it is needed.

Iodine is the main mineral for the production of the thyroid hormones. Iodine also has a
role in apoptosis (cell death) and on the immune system, as well as being an antioxidant.
Iodine combines with the amino acid tyrosine to build T4 and T3. A deficiency of iodine
intake triggers the increased secretion of TSH from the pituitary which will reduce the
production of T4. Also the balance between T4 and T3 is disturbed and T3 is nearer T4,
which should not be.

An excess of iodine will lead to the thyroid enzymes reducing their activity, which will
reduce the thyroid output and the TSH might be raised. This might induce
hypothyroidism and therefore goitre. Too little or too much can cause hypothyroidism.
The recommended daily dosage is 100 to 200 mcg (microgram). Few minerals are
essential for normal thyroid metabolism. The main ones are iodine, iron, selenium, and
zinc. A combined deficiency of these minerals can result in thyroid malfunction. Iron
deficiency disrupts thyroid hormone synthesis by reducing activity of haem-dependent
thyroid peroxidase. The combined selenium and iodine deficiency leads to
myxoedematous cretinism.

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Selenium is needed for the conversion of T4 to T3. It is a co-factor for the enzyme
iodothyronine deiodinase (DIO). Selenium has also been researched to see if it can help in
the thyroid autoimmune diseases. Selenium is antagonised by mercury. Zinc is also
involved in T3 binding to its nuclear receptor, which makes this mineral a very important
one in the thyroid function. Other nutrients such as vitamin C, and the B vitamins all
have a role in the thyroid metabolism, either directly or indirectly.

Foods which can be especially beneficial for the thyroid gland, and can help stimulate its
activity include:

 All seaweed, ionised and sea salt, sea fish for the intake of iodine
 Red meat, most fish and dairy products, almonds, avocados, bananas, lima beans,
pumpkin seeds, sesame seeds, wheat and oats, carrots, chard and all yellow foods,
various colourful foods for the intake of vitamin A
 Garlic, onions, Brazil nuts, asparagus, broccoli, mushrooms, grains for the intake
of selenium
 Grass-fed beef, crabmeat, oysters, lamb for the intake of zinc, as well as brown
rice, oatmeal, peas, whole wheat, whole rye
 Green leafy vegetables, oily fish, and dairy products, eggs, as well as sunshine for
vitamin D
 Wheatgerm, oils, avocados, green leafy vegetables for vitamin E
 All raw foods

The list above contains higher iodine or tyrosine, as well as quite a few minerals, which
are essential for the health and function of the thyroid gland.

Avoid foods which contain natural goitrogens, substances which block the synthesis of
thyroid hormone. Some foods contain small quantities of thiocynates, a potent goitrogen
that later becomes goitrin, which blocks iodine. These are:

 Cabbage
 Kale
 Peanuts
 Brussels sprouts

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 Nutrition Course – The Scientific Approach: Lesson Two

 Cauliflower
 Swede
 Broccoli
 Turnips
 Soya
 Mustard green
 Spinach

These foods are suitable to eat if cooked, because heating destroys the goitrogens in them.
Eating two to three portions should be alright for the hypothyroid person. Also white
refined foods should be avoided as they are depleted of all nutrients. Fluoridated water
and high fluoride should also be avoided if there is a thyroid problem as fluoride blocks
receptors in the thyroid gland.

Hyperthyroidism is a condition in which an overactive thyroid gland produces an

excessive amount of thyroid hormones.

Symptoms of hyperthyroidism include:

 Anxiety
 Nervousness
 Loss of weight even though eating well (but sometimes the person is anorexic)
 Loose bowels
 Breathlessness
 Hyperactive and tired at the same time
 High temperature
 Heart palpitations, with heart beating faster and with irregular pulse rate
 Staring eyes
 Shaking hands
 Skin smooth, warm and pink (thyroid flush)

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 Nutrition Course – The Scientific Approach: Lesson Two

Causes of hyperthyroidism include:

 Autoimmune (Grave’s) disease

 Toxic nodule
 Thyroxine treatments
 Excess iodine intake
 Excess TSH (very rare)
 Ovarian tumour (very rare)

Conclusion
Hormones are an essential part of how the body functions and as we will see in later
lessons, hormones can be affected by our diet and lifestyle. The thyroid has been
discussed more in this lesson, as it is more often affected by our diet and lifestyle, and
knowing what to eat and not to eat when presented with certain symptoms is an
important step with any nutritional recommendation.

© Copyright Reserved

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BIBLIOGRAPHY

Durrant-Peatfield B. (2003). The Great Thyroid Scandal and How to Survive it (2nd ed.).
London: Barons Down Publishing.
De Farias C. R. et al. (2015). A randomized-controlled, double-blind study of the impact
of selenium supplementation on thyroid autoimmunity and inflammation with focus on
the GPx1 genotypes. Journal of Endocrindological Investigation; April 17. Abstract Epub
ahead of printing (18.6.15).
Groff J. L., Gropper S. S. (2000). Advanced Nutrition and Human Metabolism (3rd ed.)
London: Thomson Learning. Also 6th ed (2012) same book. Gropper S. S. and J. Smith,
Wadsforth; CA.
Hess S.Y. (2010). The Impact of common micronutrient deficiencies on iodine and thyroid
metabolism: the evidence from human studies. Best Practice and Research Clinical
Endocrinology and Metabolism; February 24 (1). Abstract pubmed (28.6.15).
Hillson R. (1997). Thyroid disorders. London: Vermilion.
Holick M. F. (2009). Hyperparathyroidisms. In: Kohlstadt I. (ed.). Food and Nutrition in
Disease Management. USA: Taylor & Francis Group.
Murray M., Pizzorno J., Pizzorno L. (2005). The Encyclopaedia of Healing Foods. New
York: Atria Books.
Negro R. (2008). Selenium and thyroid autoimmunity. Biologics. June 2 (2).
Pearce E. N. (2015) Thyroid disorders during pregnancy and postpartum. Best Practice
and Research Clinical Obstetrics and Gynaecology. April 22. pii: S1521-6934(15)00075-9.
Abstract.
Pizzorno J. (1998). Total Wellness. USA: Prima Publishing.
Ruz M, et al. (1999). Single and multiple selenium-zinc-iodine deficiencies affect rat
thyroid metabolism and ultrastructure. The Journal of Nutrition: Vol. 129, No. 1 January.
Sedaghat K. et al. (2015). Intrauterine programming. Iranian Journal of Basic Medical
Sciences; March 18 (3).
Simopoulos A. P., Pavlou K. N. (2001). Nutrition and Fitness; Diet, Genes, Physical
Activity and Health Vol. 89. Basel: Karger.
Tenpenny S. J. (2009) Hypothyroidism: Optimising function with nutrition. In: Kohlstadt
I. (ed.). Food and Nutrition in Disease Management. USA: Taylor & Francis Group.
Tortora G. J., Anagnostakos N. P. (1990). Principles of Anatomy and Physiology. New
York: Harper Collins Publishers.

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Tortora G. J., Derrickson B. H. (2009). Principles of Anatomy and Physiology.

12th ed., vol. 1 & 2. Asia: John Wiley & Sons.
Zimmermann M. B., Köhrle J. (2002). The impact of iron and selenium deficiencies on
iodine and thyroid metabolism: biochemistry and relevance to public health. Thyroid.
October, 12 (10).
Zimmermann M. B. (2007). Interactions of Vitamin A and Iodine Deficiencies: Effects on
the Pituitary-Thyroid Axis. International Journal for Vitamin and Nutrition Research,
77(3), (Abstract 18.6.15).

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Notes
Nutrition Course – The Scientific Approach: Lesson Two
Notes
 THE BSY GROUP

NUTRITION COURSE – THE SCIENTIFIC APPROACH

QUESTIONS ON LESSON ONE

1) What are the essential nutrients for the body’s function?

2) What are the four main food groups and what would they be for a
vegetarian/vegan?
3) What is the HapMap project?
4) What is nutrigenomics?
5) In addition to diet, which two other factors can affect the occurrence of disease in
humans?
6) What are the five main reasons given by the Soil Association for choosing organic
food?
7) The use of pesticides in farming is said to have detrimental effects on human
health. What are these?
8) What nutrients are left in refined grains? State the main commercial reason for
grain polishing.
9) Would the addition of nutrients into junk food be helpful to those who are unable
to eat healthy foods? What is your opinion?
10) What are the food components that prevent the absorption of iron, zinc and
calcium?
Answer the questions as fully as possible, leaving at least two lines clear after each answer
for the tutor’s comments. Please do not use pencil or red ink. Both hand written and type
written answers are acceptable.

Complete this paper with your name and address below, and return it together with your
answer papers to The BSY Group.

STUDENT NUMBER ...........................................

NAME (MR/MRS/MISS/MS/DR) ........................................................................

ADDRESS ...................................................................................................................

.......................................................................................POSTCODE .........................