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Hypothyroidism

Allison Ulstad

Anatomy & Physiology 254

29 April, 2015
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Hypothyroidism is a condition involving the impairment of the thyroid gland, causing a

decreased production of sufficient amounts of hormones in the body (7 paraphrase). Over 20

million Americans are affected by hypothyroidism and it is significantly more common in

women, with a female to male ratio of 10:1 (7 paraphrase). The prevalence of getting

hypothyroidism is greater in patients over the age of 60. The most common cause of

hypothyroidism is due to problems with the thyroid, but other problems have to do with ones

hypothalamus and pituitary gland as well (7 paraphrase). The effects of the thyroid are extensive

throughout the entire body, and there are not many systems that the thyroid doesnt affect. This is

partially due to the thyroid hormones amalgamation with other hormones (7 paraphrase).

The thyroid gland is located inferiorly to the larynx, and is a butterfly shape. It is the

largest endocrine gland in the body, and has a bi-lobed structure often connected by an isthmus

(1, 3 paraphrase). A fully-functioning thyroid gland naturally produces two hormones, secreted

by follicular cells, called thyroxin (T4) and triiodothyronine (T4). These are called the thyroid

hormones and are made from iodine that comes from the food we eat (4, 9 paraphrase). They

have an effect throughout most of the body because there are numerous receptors for thyroid

hormones (2 & 5 paraphrase). One of the biggest effects is that the thyroid hormones increase

your basal metabolic rate. Increasing your basal metabolic rate involves elevating the cellular

metabolism of carbohydrates, lipids, and proteins (8 paraphrase). The regulation of body

temperature is another large effect from the thyroid hormones. Body temperature is regulated by

using ATP to balance the sodium and potassium ion between the extracellular fluid and the

cytosol; this process gives off heat (8 paraphrase). To make the ATP, the thyroid hormones

undergo protein synthesis and increase the expenditure of glucose and fatty acids (5 paraphrase).

Thyroid hormones also contribute to different aspects of the heart. They can enhance the actions
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of epinephrine and norepinephrine, and increase heart rate and contractility. Furthermore, they

stimulate vasodilation of the blood vessels which in turn increases blood flow to the rest of the

organs in your body (8 paraphrase).

Aside from affecting metabolic rate and body temperature, thyroid hormones also work

together with the human growth hormone and insulin to promote growth and development (6

paraphrase). The nervous and skeletal systems are the most significantly affected systems in

terms of growth due to thyroid hormones (2 paraphrase). The thyroid also contains parafollicular

cells that make the hormone calcitonin. Calcitonin can decrease the amount of calcium in the

blood by preventing osteoclast activity (allowing more storage of calcium ions); therefore the

osteoclasts can no longer break down bone (6 paraphrase). Calcitonins effects counteract those

of the parathyroid hormone, so the two hormones regulate the homeostasis of calcium,

magnesium, and phosphate (6 paraphrase).

The thyroid gland not only has a unique effect on the body, but it is also the only gland to

make and secrete its own hormones. The thyroid gland can store large amounts of thyroid

hormones before they are secreted (2, 3, & 11 paraphrase). The vast majority of thyroxine and

triiodothyronine are transported through the blood by attaching onto transport proteins. The

hypothalamus secretes thyrotropin-releasing hormone (TRH) and the adenohypophysis secretes

thyroid stimulating hormone (thyrotropin/TSH), which stimulates synthesis and release of the

thyroid hormones (2 & 3 paraphrase). The hypothalamus produces TRH when it recognizes low

levels of thyroid hormones in the bloodstream (2 paraphrase).

The most common cause of hypothyroidism is Hashimotos thyroiditis. It causes swelling

and inflammation of the thyroid and can cause damage to cells (7&8 paraphrase). This is an
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autoimmune disorder where the body produces antibodies that kill its own cells, so the antibodies

inhibit hormone secretion (2 paraphrase). Other causes of hypothyroidism include a patient

given too much anti-thyroid medication, a surgically removed thyroid (no thyroid means no

production of thyroid hormones), medications such as lithium (may lower thyroid hormone

secretion), congenital disease, pregnancy, pituitary disorder (does not secrete enough TSH,

therefore, the thyroid isnt being told to produce/secrete hormones), and iodine deficiency

(building block for (T3) and (T4)) (2 paraphrase). Iodine deficiencies are among the least

common causes in the U.S. because iodine comes from the food we eat, and most foods have

added iodine (9 paraphrase).

Hypothyroidism is caused by a variety of factors, yet it is mainly diagnosed by a TSH

blood level test. When TSH levels are high, it is a sign of Hypothyroidism, because the thyroid is

not responding to the TSH levels, so the pituitary gland keeps secreting more TSH until the

thyroid reacts normally (2 paraphrase). Although this occurrence is less common, if TSH levels

are low, as well as Thyroxine and Triiodothyronine, this is indicative of hypothyroidism due to

problems with the pituitary gland releasing TSH (12 paraphrase).

The symptoms of hypothyroidism include fatigue, weight gain, goiter (inflamed thyroid),

puffy face, cold intolerance, joint and muscle pain, constipation, dry skin, thinning hair,

decreased sweating, heavy or irregular periods for women, infertility, depression, and a slowed

heart rate (1 paraphrase).

Treatment for hypothyroidism is synthetic levothyroxine (T4), which is orally ingested

every day for life. Doctor visits and dosage changes may occur as well. Even with proper dosage,

the body takes at least a week to adjust (pregnant women need to increase dosage by 25-50
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percent) (12 paraphrase). Another treatment for hypothyroidism is iodine supplements or

increasing iodine consumption in ones diet. Iodine helps with T3 and T4 levels in the blood, but

it can cause a large scale autoimmune attack on the thyroid (9, 12 paraphrase). An Armour

thyroid (derivative of dehydrated pig thyroid gland) was another treatment as well. This was the

best option before levothyroxine, but it has a severe disadvantage. The dosage is an issue

because it is not in terms of milligrams but of thyroid grains (can fluctuate greatly between pig

specimens). This means that dosages may be off and it is hard for doctors to determine how

much to give. All in all, regulating hormones of the body is the main concern (12 paraphrase).

If treated properly, mortality rates are low, but if not detected or treated, hypothyroidism

can lead to heart disease, heart failure, pneumonia, and Myxedema coma can result (10

paraphrase). This occurs most often among the elderly, and symptoms include coldness, trouble

breathing, slow heart rate, and loss of consciousness. Tissues become inflamed and fluid can

surround the heart (10 paraphrase). Once detected, there is a 50 percent mortality rate.

Hypothyroidism is a common endocrine disorder with many different etiologies. It is an

unpreventable disease that may be present with abnormalities in metabolism and development (7

paraphrase). If left untreated it can result in one of the most serious endocrine emergencies.

Hypothyroidism may present in patients in a subtle manner, with the manifestations being

mistaken for the natural course of aging (2, 5 paraphrase). Therefore, depending on the cause, if

the disease is treated in a timely manner then that patient has a greater chance of life. To identify

potential causes of hypothyroidism a diagnosis relies on a detailed history and physical exam.

The key tests are serum TSH and free T4 levels (2, 5 paraphrase). The importance of these tests

are not only required for the diagnosis of the condition, but also for the long-term management

of the patient. Once treatment has been initiated, therapy is continued throughout life,
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Works Cited

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