Disorders of the Thyroid

Actions of the thyroid

Controls body temperature
How body burns calories
Controls how fast food
moves through digestive
tract
Muscle strength
Thyroid hormones:
T3-thyroxine
T4-triiodothyronine
Calcitonin
Normal Thyroid Gland
Synthesis of thyroid hormone depends upon
sufficient quantities of iodine from dietary
source. The rate of extraction of iodine from
the blood stream and the rate at which T
3
and
T
4
and synthesized and released from storage
(as thyroglobulin) and secreted into the
bloodstream are regulated by pituitary TSH.
TSH is regulated by Thyrotropin-Releasing
hormone from hypothalamus. Serum T
3
and
T
4
are bound to albumin and thyroid-binding
globulin (TBG).
Hyperthyroidism is present when the thyroid
gland is over secreting hormones.
Thus, increasing the metabolic rate of the body
and speeding up the body.
Hyperthyroidism
Graves disease(autoimmune disorder ).
A benign nodule on the thyroid.
Thyroiditis.
Taking too much of the synthetic thyroid
hormone.

Causes of Hyperthyroidism
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
Nervousness
Restlessness
Anxiety
Irritability
Sleeplessness or insomnia
Exhaustion


Emotional Symptoms of
Hyperthyroidism
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. Total
T4 levels should be at 5-14 mcg/dL.
Diagnostics
Who is more prone to develop
Graves disease??


Female are more prone to
developing Graves disease along
with Hyperthyroidism. Due to a
genetic background of both
disorders, I have a greater risk.
With Graves Disease, the immune system begins
to attack the thyroid and produces antibodies
that mimic TSH.
Women are more likely to develop Graves
disease.
Hereditary and environmental influences.
Graves Disease
Goiter:
It is a general term for enlargement of thyroid
gland.It occurs whenever there is elevation of TSH or
TSI.
Goiter may occurs in hypothyroidism (as low thyroid
hormones in low iodine with increase TSH), and
hyperthyroidism (hyper-secretion of TSH caused by
hypothalamic or pituitary causes or Graves disease
with increase TSI).
It is caused by: OPhysiological enlargement: it is
seen mostly in puberty and pregnancyOIodine
deficiency: it occurs in geographic area where diet is
deficient in iodine O Hashimotos thyroiditis O
Goitrogens: they are foods or drugs that suppress
synthesis of thyroid hormone.
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
Hypothyroidism is present when the thyroid
gland is producing little or no thyroid
hormones. Thus slowing things down....
Hypothyroidism
Thyroiditis
Treatment for hyperthyroidism
Congenital hypothyroidism
Radiation therapy given to the head and/or
neck
Causes of Hypothyroidism
Myxedema: it is more common
in women than men. It is
manifested in adult. CPuffiness of
face, eyelids and handsC Dry
skinCHair loss, coarse and brittle
hair, scant axillary and pubic hair,
thining of the lateral aspect of the
eyebrowC increase in relaxation
phase of deep tendon reflex.
Cases of myxedema: OTherapy for
hyperthyroidism with surgery, irradiation, or
drugs is the most common cause of
myxedema in US.OUnknown cause (primary
idio-pathic myxedema) is secondary most
common form of myxedema, which may be
of auto-immune origin. OHashimotos
thyroiditisODrugs (as Lithium
carbonate)OIodine deficiency: is the most
important causes in some geographic area
(Himalayas, Andes and central Africa).
Clinical characteristics of myxedema:OGeneral:
Tiredness, somnolence, weight gain, and cold
intoleranceOCVS: bradycardia, hypertension, angina,
cardiac failureOCNS: delay relaxation of tendon,
depression,mental and physical slowness, muscle
stiffness ODermatology: Dry skin, alopecia, Puffiness
of face, eyelid, and handsOReproduction: Menorrhagia,
impotanceOGIT: constipation.
Cretinism: It is manifested in children. It is
characterized by: OSever mental
retardationOimpairment of physical growth with
retardate bone development and dwarfismOlarge
tongueOprotuberant abdomen.


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 from
breasts


Symptoms of Hypothyroidism
Hypothyroidism can be linked to psychiatric
depression.
Roughly 15% of all patients suffering from
depression are found to be hypothyroid.

Some symptoms found are:
Paranoia
Aural and Visual hallucinations

Emotional Symptoms of
Hypothyroidism
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. Total
T4 levels should be at 5-14 mcg/dL.
Diagnostics
Thyroid replacement pills-most common
Some medicines can cause hypothyroidism.
Stop the medication and symptoms should cease.
Treatment of Hypothyroidism