HYPOTHYROIDISM

INTRODUCTION

• Thyroid gland is the largest endocrine gland

• Weight = 15-20 g(adult)
• thyroid gland secretes 2 hormone thyroxine and Tetraidothyronine
• thyroid secretion is controlled primarily by thyroid stimulating hormone secreted by anterior pituitary
gland
PHYSIOLOGICAL ANATOMY OF THYROID GLAND
• thyroid gland consist of a large number of follicles that are filled with secretory substance called
colloid
• line with cuboidal epithelium constituents of colloid is the large glycoprotein molecule
thyroglobulin
• thyroid gland has a blood flow about five times the weight of the gland each minute

Synthesis of thyroid hormone

• T4 and T3 are iodine containing derivative of thyronine which is a condensation product

of two molecule of amino acid tyrosine .
• 93% off the metabolically active hormones secreted by the thyroid gland are thyroxine
and 7% is triiodothyronine
BIOSYNTHESIS OF THYROID HORMONE

Five steps are involved in biosynthesis of thyroid hormone

• Iodine trapping
• Oxidation of iodine ion
• organification of thyroglobulin
• Coupling of Idotyrosine residue
• Release of T3 and T4 into blood
DISEASE OF THYROID GLAND HYPERTHYROIDISM

• Condition in which thyroid gland doesn’t produce enough thyroid hormone

• Hypothyroidism more prevalent in older women
• hypothyroidism in children leads to delays in growth and intellectual development which is
called cretinism
TYPES OF HYPOTHYROIDISM
• Primary hypothyroidism--->destruction of the thyroid gland by autoimmune disease or by
ablative therapies
• Secondary hypothyroidism--->pituitary gland dysfunction that result in a diminished
secreation of biologically active TSH
• Tertiary hypothyroidism--->hypothalamic dysfunction that result in a decrease production or
reduce delivery of TRH to the pituitary gland
PATHOGENESIS OF HYPOTHYROIDISM

• Characteristic finding: accommodation of glycosaminoglycans mostly hyaluronic acid in

interstitial tissue
• The accumulation is due not to excessive synthesis but to decrease destruction of
glycosaminoglycans
• accumulation of this hydrophilic substance and increased capillary permeability to albumin
account for this interstitial edema this is particularly evident in skin heart muscle and striated
muscle
MAJOR CAUSE OF HYPOTHYROIDISM

Central hypothyroidism
• TSH deficiency
• TRH deficiency
Primary hypothyroidism
• Chronic autoimmune thyroiditis
• Thyroidectomy
• Radioiodine therapy
• Iodine deficiency or excess
• Drugs like thionamids lithium amiodarone, perchlorate