4. Mr. Holdt brings his wife to the clinic, concerned
about her nervousness, heart palpitations, and
excessive sweating. Tests show hypergycemia and
hypertension. What hormones are probably being
hypersecreted? What is the cause? What physical
factors allow you to rule out thyroid problems?
Janetta Osborne
Period 1
Hyperthyroidism
• Hyperthyroidism is a condition in which the
thyroid gland makes too much thyroid
hormone. The condition is often referred to as
an "overactive thyroid.“
• thyroxine (T4) and triiodothyronine (T3), are
tyrosine-based hormones produced by the
thyroid gland – they help regulate a person’s
metabolism.
About the thyroid
• The thyroid gland or simply, the thyroid is one of the largest
endocrine glands. The thyroid gland is found in the neck, below the
Adam's apple.
• The thyroid gland controls how quickly the body uses energy, makes
proteins, and controls how sensitive the body is to other hormones.
It participates in these processes by producing thyroid hormones.
• The thyroid gland is a butterfly-shaped organ and is composed of
two cone-like lobes or wings, lobus dexter (right lobe) and lobus
sinister (left lobe), connected via the isthmus. The organ lyes
against and around the larynx and trachea.
• The thyroid gland is covered by a fibrous sheath, the capsula
glandulae thyroidea, composed of an internal and external layer.
Causes/Risk Factors
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The thyroid gland is an important organ of the endocrine system. It is located in
the front of the neck just below the voice box.
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The gland produces the hormones thyroxine and triiodothyronine , they control
how the body uses energy. This process is called your metabolism.
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Hyperthyroidism occurs when the thyroid releases too much of its hormones over
a short (acute) or long (chronic) period of time.
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Diseases and issues linked with this particular ailment are:
Getting too much iodine
Graves disease (accounts for most cases of hyperthyroidism)
Inflammation of the thyroid (infection)
Noncancerous growths of the thyroid gland or pituitary gland
Taking large amounts of thyroid hormone
Tumors of the testes or ovaries
Symptoms
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Symptoms
Difficulty concentrating
Fatigue
Frequent bowel movements
Goiter (visibly enlarged thyroid gland) or thyroid nodules
Heat intolerance
Increased appetite
Increased sweating
Irregular menstrual periods in women
Nervousness
Restlessness
Weight loss (rarely, weight gain)
Tests and Diagnostic
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Signs and tests
Tests may reveal thyroid enlargement, tremors, hyperactive reflexes, or an
increased heart rate.
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Also- Systolic blood pressure (the first number in a blood pressure reading) may be
high.
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Subclinical hyperthyroidism (mild form of hyperthyroidism) is diagnosed by
abnormal blood levels of thyroid hormones.
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Blood tests are also done to measure levels of thyroid hormones.
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When testing and diagnosed the TSH (thyroid stimulating hormone) level is usually
low
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And T3 and free T4 levels are usually high
Treatment
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Treatment depends on the cause or the severity of symptoms.
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Hyperthyroidism treatment includes:
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Antithyroid medications (prevent the thyroid from producing excess amounts of
hormone)
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Radioactive iodine (destroys the thyroid and stops the excess production of hormones)
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Surgery to remove the thyroid
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If the thyroid must be removed with surgery or destroyed with radiation, you must take
thyroid hormone replacement pills for the rest of your life.
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Beta-blockers such as propranolol are used to treat some of the symptoms, including
rapid heart rate, sweating, and anxiety until the hyperthyroidism can be controlled.
Prognosis
• Hyperthyroidism is generally treatable and it is seldom life
threatening. Some of its causes may go away without
treatment.
• Hyperthyroidism caused by Graves disease (autoimmune
disorder that leads to over- activity of the thyroid gland)
usually gets worse over time.
• Unfortunately, Thyroid crisis (storm), also called
thyrotoxicosis, is a sudden worsening of hyperthyroidism
symptoms that may occur with infection or stress. Fever,
decreased mental alertness, and abdominal pain may
occur. And immediate hospitalization is needed.