thyroid

Question 1

Thyroid Horomones

horomones act as cellular energy release catalysts and influence fx and health of all cells

Answer 1

Healthy thyroid gland releases 100-125 mcg of T4 and very sm T3 amount
T4=1/2 life 7-10 days
T3-4x >in metabolically active than T4
Free T4 and TSH —–50% < in FT4 causes 90 fold < in TSH.
Low TSH/high T4-hyperthyroidism
High TSH/lowFT4-hypo

Question 2

Medication intervention
T4
Levothyroxine
(levoxyl, Synthroid, Levothyroid)

Answer 2

Calculating levothyroxine
1.6mcg/kg/day/adult–do not treat kids
1.0………………/elderly
start @ 50%of anticipated dose–increase 25%
***note increased need 1/3 33% in pregnancy

Question 3

T4 Best Practice

Answer 3

Maintain same manufacture product--mark no generic if sensitive.
take on empty stomach
same time odsage daily
do not take with metals
recheck levels @4-6 weeks
goal -normal TSH

Question 4

T4 considerations

Answer 4

Increased dose 
       ****pregnancy 33%^
       adding HRT
        drug interation-^clearance
             Rifampin,tegretol, phytoin
Decreased dosage
        Aging
         Removal of drug which alter clearance.

Question 5

Adverse effects

Answer 5

increased thyroid s/s

Question 6

Drug interaction Amiodarone

Monitor TSHq6 months

Answer 6

free iodine 6mg/200mg tab—
-thyrotoxicosis
iodine deficiency area most common
preexisting thyroid disease
-hypothyroidism
interferes with conversion of T3–T4
iodine sufficient areas-more common

Question 7

Drug interaction Lithium

Monitor TSH q6 months

Answer 7

hypothyroidism
<release of thyroid hormone
^risk with subclinical disease
increase dosage T$ as needed.

Question 8

Armour Thyroid Natural

pig product

Answer 8

contains T4 and T3
ratio 4.33 to 1
dosage in grains
1 grain=100mcg of traditional L4

Question 9

Hyperthyroid

Answer 9

Only treat til gets into endocrinologist.
******PTU Propythiouracil,
         methimazole MMI
Beta blocker  symptom relief 
         relief of tremor
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