Disorders of the Thyroid1

7/31/2019 Disorders of the Thyroid1

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Disorders of the Thyroid


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Actions of the thyroid Controls body temperature How body burns calories Controls how fast food

moves through digestivetract Muscle strength

Thyroid hormones: T3-thyroxine T4-triiodothyronine Calcitonin

Normal Thyroid Gland


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Synthesis of thyroid hormone depends uponsufficient quantities of iodine from dietarysource. The rate of extraction of iodine fromthe blood stream and the rate at which T 3 andT4 and synthesized and released from storage

(as thyroglobulin) and secreted into thebloodstream are regulated by pituitary TSH.TSH is regulated by Thyrotropin-Releasing

hormone from hypothalamus. Serum T 3 andT4 are bound to albumin and thyroid-bindingglobulin (TBG).


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Hyperthyroidism is present when the thyroidgland is over secreting hormones.

Thus, increasing the metabolic rate of the bodyand speeding up the body.

Hyperthyroidism


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Graves disease(autoimmune disorder ). A benign nodule on the thyroid.

Thyroiditis. Taking too much of the synthetic thyroid

hormone.

Causes of Hyperthyroidism
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Diarrhea and weight loss Eye problems Enlarged thyroid gland

Hair and skin changes Heat intolerance Heart palpitations Clubbing Menstrual cycle changes Muscle weakness Easily bruised

Symptoms of Hyperthyroidism
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Nervousness Restlessness

Anxiety Irritability Sleeplessness or insomnia Exhaustion

Emotional Symptoms of Hyperthyroidism


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How do we diagnosis these disorders?? Thyroid stimulation hormone (TSH) test

Normal levels of TSH are 0.4-4.5milliunits/L. Thyroid hormone test

In adults, a normal total T3 level is 80-230 ng/dL. TotalT4 levels should be at 5-14 mcg/dL.

Diagnostics


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Who is more prone to developGraves disease??

Female are more prone to

developing Graves disease alongwith Hyperthyroidism. Due to agenetic background of both

disorders, I have a greater risk.


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With Graves Disease, the immune system beginsto attack the thyroid and produces antibodiesthat mimic TSH.

Women are more likely to develop Gravesdisease.

Hereditary and environmental influences.

Graves Disease


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Goiter :It is a general term for enlargement of thyroid

gland.It occurs whenever there is elevation of TSH orTSI.

Goiter may occurs in hypothyroidism (as low thyroidhormones in low iodine with increase TSH), andhyperthyroidism (hyper-secretion of TSH caused by

hypothalamic or pituitary causes or Graves diseasewith increase TSI).It is caused by: Physiological enlargement: it is

seen mostly in puberty and pregnancy Iodinedeficiency: it occurs in geographic area where diet isdeficient in iodine Hashimotos thyroiditis Goitrogens: they are foods or drugs that suppresssynthesis of thyroid hormone.


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Radioactive iodine Typical treatment is 3-12 millicuries. However, this treatment can cause hypothyroidism. It must also be followed by thyroid replacing

hormones. Beta-Blockers Antithyroid medication-Propylthiouracil (PTU) or

Tapazole

Treatments for Hyperthyroidism


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Hypothyroidism is present when the thyroidgland is producing little or no thyroidhormones. Thus slowing things down....

Hypothyroidism


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Thyroiditis Treatment for hyperthyroidism

Congenital hypothyroidism Radiation therapy given to the head and/or

neck

Causes of Hypothyroidism


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Myxedema: it is more commonin women than men. It is

manifested in adult. Puffiness of face, eyelids and hands Dryskin Hair loss, coarse and brittle

hair, scant axillary and pubic hair,thining of the lateral aspect of theeyebrow increase in relaxation

phase of deep tendon reflex.


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Cases of myxedema: Therapy forhyperthyroidism with surgery, irradiation, or

drugs is the most common cause of myxedema in US. Unknown cause (primaryidio-pathic myxedema) is secondary most

common form of myxedema, which may beof auto-immune origin. Hashimotosthyroiditis Drugs (as Lithium

carbonate) Iodine deficiency: is the mostimportant causes in some geographic area(Himalayas, Andes and central Africa).


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Clinical characteristics of myxedema: General:Tiredness, somnolence, weight gain, and cold

intolerance CVS: bradycardia, hypertension, angina,cardiac failure CNS: delay relaxation of tendon,depression,mental and physical slowness, musclestiffness Dermatology: Dry skin, alopecia, Puffinessof face, eyelid, and hands Reproduction: Menorrhagia,impotance GIT: constipation.Cretinism: It is manifested in children. It ischaracterized by: Sever mentalretardation impairment of physical growth withretardate bone development and dwarfism largetongue protuberant abdomen.


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Cold intolerance Slow digestion Weight gain Fatigue Thin, coarse hair Brittle fingernails Muscle aches Dizziness

Ringing in ears Numbness

Carpal tunnel

Poor memory Skin changes Voice changes

Milky discharge frombreasts

Symptoms of Hypothyroidism


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Hypothyroidism can be linked to psychiatricdepression.

Roughly 15% of all patients suffering fromdepression are found to be hypothyroid.

Some symptoms found are:ParanoiaAural and Visual hallucinations

Emotional Symptoms of Hypothyroidism


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How do we diagnosis these disorders?? Thyroid stimulation hormone (TSH) test

Normal levels of TSH are 0.4-4.5milliunits/L. Thyroid hormone test

In adults, a normal total T3 level is 80-230 ng/dL. TotalT4 levels should be at 5-14 mcg/dL.

Diagnostics


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Thyroid replacement pills-most common Some medicines can cause hypothyroidism.

Stop the medication and symptoms should cease.

Treatment of Hypothyroidism

Disorders of the Thyroid1

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