Research Task: Hypothyroidism and Hyperthyroidism Flashcards
Where is the thyroid gland located and what is its structure?
-Located in the neck, just below the larynx
-Consists of two lobes on either side of the trachea
What hormones does the thyroid gland secrete?
-Thyroxine (T4)
-Triiodothyronine (T3)
What is the main role of thyroxine (T4)?
Regulates body metabolism and helps release energy, some of which is used to maintain body temperature
How does the thyroid contribute to calcium homeostasis?
It releases calcitonin, which lowers blood calcium levels by inhibiting bone breakdown
What hormone stimulates the thyroid gland to produce hormones?
Thyroid stimulating hormone (TSH) from the anterior pituitary gland
How does the thyroid maintain homeostasis?
By regulating metabolism (via T4 and T3) and calcium levels (via calcitonin)
What are the causes of hyperthyroidism?
-Graves disease
-Thyroid nodules
-Excessive iodine intake
-Overmedication
What are the causes of hypothyroidism?
-Hashimoto’s disease
-Iodine deficiency
-Surgery/radiation
-Congenital hypothyroidism
-Lithium
What groups are at risk of hypothyroidism?
-Older women (aged 60)
-People with autoimmune diseases
-Iodine deficiency
-Thyroid surgery patients
-Newborns with congenital hypothyroidism
-People taking medication like lithium
What groups are at risk of hyperthyroidism?
-Women (especially 20-40)
-People with autoimmune diseases or family history
-Elderly with thyroid nodules
-Excess iodine users
-Overmedicated patients
What are the symptoms of Graves disease
-Feelings of irritability and nervousness
-Heat sensitivity
-Weight loss
-Goitre
-Menstrual changes
-Frequent bowl movements
-Bulging eyes
-Fast/irregular heartbeat
What are the symptoms of Hashimoto’s disease?
-Fatigue and sluggishness
-Increases sensitivity to cold
-Increased sleepiness
-Dry skin
-Constipated
-Muscles weakness
-Joint pain and stiffness
-Problems with memory and concentration
-Swelling of goitre
-Puffy face
Why do people with graves disease feel irritable and nervousness?
Excess thyroid hormone speeds up the activity of nervous system
Why are people with graves disease sensitive to heat?
An increases metabolic rate causes body temperature to increase too
Why do people with Graves disease lose weight?
The excess thyroid hormone increases the BMR, causing the body to burn more calories
Why do people with Graves disease have enlarged thyroid gland (goitre)
Thyroid may enlarge due to overstimulation by the immune system which causes to produce more hormones
Why do people that have Graves disease have menstrual cycle changes?
Excess thyroid hormones can disrupt the regularity of the menstrual cycle by affect the balance of other hormones
Why do people with Graves disease have increased bowel movements?
Thyroid hormone increases guy mobility, meaning the digestive system works faster
Why do people with Graves disease have bulging eyes?
The immune system also targets the tissues around the eyes causing the swelling.
Why do people with Graves disease have a fast/irregular heartbeat?
Excess thyroid hormones stimulate the heart rate because of the increase metabolic rate.
Why do people with Hashimoto’s disease feel fatigued or sluggish?
Low thyroid hormone levels slow down the body’s metabolism, making people feel tired and sluggish as the body uses energy inefficiently
Why are people with Hashimoto’s disease sensitive to cold?
Thyroid hormones helps regulate body temperature. When levels are too low, the body’s ability to generate heat is impaired
Why do people with Hashimoto’s disease feel sleepy?
Hypothyroidism slows metabolic processes and can disrupt the body’s sleep-wake cycle
Why do people with Hashimoto’s disease have dry skin?
Thyroid hormones help regulate skin health by maintaining moisture. When thyroid hormones are low, the skin becomes dry and rough due to reduced moisture retention
Why are people that have Hashimoto’s disease constipated?
Low thyroid hormones slows down the digestive system leading to constipation and slower bowel movements.
Why do people with Hashimoto’s disease have muscle weakness?
Low thyroid hormone levels slow down muscle metabolism by reducing energy production
Why do people with Hashimoto’s disease have joint and pain stiffness?
The lack of thyroid hormones can cause fluid retention and inflammation in the joints.
Why do people with Hashimoto’s disease have problems with concentration and memory?
Hypothyroidism can affect brain function by slowing down cognitive processes, leading to memory problems.
Why do people with Hashimoto’s disease have swollen gotre
The thyroid becomes swollen and inflamed because of the immune system’s attack and it attempts to compensate for the lower hormone production
Why do people with Hashimoto’s disease have a puffy face?
Low thyroid function causes fluid retention and swelling in the face, giving it a puffy appearance.
How is Graves disease diagnosed?
-Physical examination
-Blood tests such as Thyroid Function tests and Thyroid Antibody tests
-Radioactive Iodine Uptake (RAI) test
How is Hashimoto’s disease diagnosed?
-Physical examination
-Blood tests such as Thyroid Function tests and Thyroid Antibody tests
-Ultrasound Imaging
How can a physical examination help diagnose Graves disease?
A healthcare provider assesses symptoms such as goitre and bulging eyes as they are characteristics of Graves’ disease.
How can Thyroid Function tests help diagnose Graves disease?
-The test measures Thyroid Stimulating Hormone (TSH) and thyroid hormones (T4 and T3)
-In Graves’ disease TSH levels are usually low due to the negative feedback from the elevated thyroid hormones.
How can Thyroid Antibody tests help diagnose Graves disease?
Thyroid Antibody Tests are conducted to detect antibodies like Thyroid-Stimulating Immunoglobulins (TSI), which stimulate the thyroid gland, confirming the autoimmune nature of the disease.
How can Radioactive Iodine Uptake (RAI) help diagnose Graves disease?
-RAI test may be conducted to assess how much iodine the thyroid absorbs.
-In Graves’ disease, the thyroid absorbs increased amounts of iodine due to its overactivity.
How can a thyroid scan help diagnose Graves disease?
A thyroid Scan may be performed to visualise the size, shape, and activity of the thyroid, helping to differentiate Graves’ disease from other thyroid disorders.
How can a physical examination help diagnose Hashimoto’s disease?
The physical examination often focuses on detecting a goitre, which may develop due to the inflammation of the thyroid, and assessing symptoms related to hypothyroidism, such as fatigue, sensitivity to cold, and weight gain
How can Thyroid Function Tests examination help diagnose Hashimoto’s disease?
Thyroid Function Tests measure TSH and thyroid hormones (T₄). In Hashimoto’s disease, TSH levels are typically elevated because the thyroid is under active, while T₄ levels are low due to the thyroid’s inability to produce enough hormones.
How can Thyroid Antibody Tests examination help diagnose Hashimoto’s disease?
Thyroid Antibody Tests help confirm the autoimmune nature of the disease by detecting antibodies such as Thyroid Peroxidase (TPO) and Thyroglobulin antibodies, which attack the thyroid tissue.
How can Ultrasound image examination help diagnose Hashimoto’s disease?
Used to assess the size and texture of the thyroid. This imaging can reveal signs of thyroid inflammation and help identify structural changes associated with Hashimoto’s disease.
What are some possible treatments used for Graves disease?
-Anti-thyroid medication (such as carbimazole or methimazole)
-Radioactive iodine therapy
-Thyroidectomy (Surgery)
What are some possible treatments used for Hashimoto’s disease?
-Medication such as using a synthetic form of T4 (Levothyroxine)
What are the side effects and the risks associated with the treatment of anti-thyroid medications for Graves disease?
Common side effects are:
-Skin rashes
-Itching
-Nausea
-Gastrointestinal discomfort
Serious but rare risks are:
-Agranulocytosis (a significant decrease in white blood cells leading to increased infections
-Liver toxicity
What are the side effects and the risks associated with the treatment of Radioactive Iodine Therapy for Graves disease?
Short-term side effects are:
-Neck tenderness
-Salivary gland swelling
-Dry mouth
-Taste changes
-Nausea
Long-term consequences is:
-Hypothyroidism
Radioactive Iodine therapy is not used on pregnant or breastfeeding women due to potential harm to the developing foetus or infant.
What are the side effects and the risks associated with the treatment of thyroidectomy for Graves disease?
Risks include:
-Damage to the parathyroids (leading to calcium imbalances)
-Injury to the recurrent laryngeal nerve (can cause voice changes)
Patients who have Graves disease and has had thyroidectomy, what must they take after the surgery?
After the surgery, patients are typically require to take lifelong thyroid hormone replacements due to the loss of natural hormone production.
What are the side effects and the risks associated with the treatment of Thyroid hormone replacement therapy for Hashimoto’s disease?
-Levothyroxine
Side effects are generally related to inaaprioate dosing. They include:
-Hyperthyroidism
-Insomnia
-Increased appetite
While under dosage may be result in persistent hypothyroid symptoms.
For Graves disease, what does antithyroid medications do to help treat the disease?
Anti-thyroid medications, such as methimazole and carbimazole, work by inhibiting the thyroid gland’s ability to produce thyroid hormones.
For Graves disease, what does Radioactive iodine Therapy do to help treat the disease?
It involves administrating radioactive iodine-131 orally, which the overactive thyroid cells absorb, leading to their destruction
For Graves disease, what does thyroidectomy do to help treat the disease?
-It is the surgical removal of the thyroid gland which helps to treats Graves disease by removing the overactive thyroid.
For Hashimoto’s disease, what does thyroid hormone replacement therapy do in help treat the disease?
Levothyroxine is a synthetic form of thyroxine (T4) that is used to treat hypothyroidism by helping to restore low levels of thyroxine.
For hypothyroidism, why are women over 60 at risk?
Because age and female hormones make immune conditions more likely
For hypothyroidism, why are people with a family history of thyroid or autoimmune diseases at risk?
Because genetic predisposition increases the chance of thyroid gland failure
For hypothyroidism, why are people with autoimmune diseases at risk?
They are at risk because autoimmune diseases often co-occur and the immune system may target thyroid cells destroying hormone producing tissue.
For hypothyroidism, why are people with iodine deficiency thyroid at risk?
They are at risk because without iodine, the thyroid cannot make thyroxine (T4)
For hypothyroidism, why are people with surgery or radiation at risk?
Because surgery or raidation removes or destroys part of the thyroid and less or no thyroid tissue means less hormone is produced.
For hypothyroidism, why are newborns with congenital hypothyroidism at risk?
Because they are born with undeveloped or missing thyroid and without a functioning thyroid the baby can’t make hormones, which may affect growth and brain development
For hypothyroidism, why are people taking medication like lithium at risk?
Lithium is used to treat bipolar disorder and can affect thyroid function. Lithium interferes with iodine uptake by the thyroid, preventing the thyroid from producing enough hormones, leading to hypothyroidism.
For hyperthyroidism, why are women who are aged 20-40 at risk?
Women are more prone to autoimmune diseases due to hormonal and immune system differences.
For hyperthyroidism, why are people with a family history of thyroid or autoimmune diseases at risk?
Thyroid conditions like Graves’ disease often run in families, suggesting a genetic link. Inherited immune system traits can lead to abnormal stimulation of the thyroid gland.
For hyperthyroidism, why are people with autoimmune conditions (e.g., type 1 diabetes) at risk?
Having one autoimmune disorder increases the risk of developing others. The immune system may mistakenly attack or stimulate the thyroid, increasing hormone production.
For hyperthyroidism, why are older people with thyroid nodules (especially women) are at risk?
Thyroid nodules are more common with age and can become overactive. Some nodules produce hormones independently of brain signals, leading to excess thyroxine.
For hyperthyroidism, why are people who are taking excessive iodine are at risk?
Iodine is needed for thyroxine production. Too much can overstimulate the thyroid in sensitive individuals.
For hyperthyroidism, why are people who are overmedicated with thyroid hormone at risk?
Taking more synthetic thyroxine than needed raises hormone levels.
Draw a feedback loop for hyperthyroidism
Stimulus
-↑ levels of T4 and T3
Receptors
-Chemoreceptors detect ↑ levels of T4 and T3
Message
-Nerve impulse is sent to the hypothalamus which then secretes TSH IF (inhibiting factor) to the pituitary gland
Modulator
-The pituitary gland then ↓ the levels of TSH
Message
-↓ levels of TSH
Effector
-Thyroid is effected
Responce
-↓ T4 and T3
Feedback
-Negative feedback
-T4 and T3 levels are no longer elevated
Draw a feedback loop for hypothyroidism
Stimulus
-↓ levels of T4 and T3
Receptors
-Chemoreceptors detect ↓ levels of T4 and T3
Message
-Nerve impulse is sent to the hypothalamus which then secretes TSH RF (releasing factor) to the pituitary gland
Modulator
-The pituitary gland then ↑ the levels of TSH
Message
-↓ levels of TSH
Effector
-Thyroid is effected
Responce
-↑ T4 and T3
Feedback
-Negative feedback
-T4 and T3 levels are no longer low.
