Alexis Jonathan Lamsen

Thyroid Glands ✦ A thyroid gland is a 2-inch butterfly-shaped organ located at the front of the neck just below the adam’s apple. ✦ It is controlled by thyrotrophin relasing hormone (TRH) from the hypothalamus in the brain and by the thyroid stimulating hormone (TSH) produced by the pituitary gland. Thyroid Glands ✦ Though the thyroid gland is small, it’s a major gland in the endocrine system and affects nearly every organ in the body. Thyroid Glands Vital Role Making and producing hormones for regulating:! !✦ Heart Rate! ✦ Blood Pressure! ✦ Cholesterol Level! ✦ Blood Calcium Level! ✦ Respiration! ✦ Digestive functions! ✦ Body Temperature Thyroid Glands Vital Role Making and producing hormones for regulating:! !✦ Body’a Metabolic Rate ! ✦ Muscle Control ! ✦ Brain Development! ✦ Menstrual Cycle! ✦ Skin Integrity! ✦ Maintence of Bones Thyroid Glands Types of Hormones The thyroid gland secretes several hormones collectively called thyroid hormones. These are: ! !✦ Thyroxine (also called T4), ! ✦ Triiodothyronine (also called T3) ! ✦ Calcitonin (CT) Thyroid Glands Hormones ✦ T4 (Thyroxine) is the most abundant thyroid hormone and considered as our main hormone. ✦ T3 (Triiodothyronine) is the more potent and considered to be the principal thyroid hormone. ✦ In order for T4 to be produced, the diet must contain sufficient amount of iodine. What is Thyroxin (T4)? ✦ Thyroxin is the main hormone secreted into blood stream by the thyroid gland. ✦ It is the inactive form and most of it it is converted to an active form called triiodothyrine by organs such as the liver and kidneys. What is a Thyroid Disease? Thyroid disease is a disorder results when thyroid produces more or less thyroid hormone. It is classified into three groups: !✦ HYPOTHYRODISM (too little/ insufficient thyroid hormone production) ✦ HYPERTHYRODISM (too much thyroid hormone ! production)! ✦ GOITER (nodule or enlargement of thyroid glands) What is Hypothyrodism? ✦ also known as under active thyroid, is the most common thyroid condition. ✦ it is a condition where the thyroid does not create enough of a thyroid hormone called thyroxin. Thyroid hormones regulate the way in which the body uses energy metabolism and without enough thyroxin many of the body’s function slow down. Causes of Hypothyrodism ✦ is usually is caused by an autoimmune response known as Hashimoto’s Disease or Autoimmune Thyroiditis. ! Hashimoto’s Disease! ✦ As with all autoimmune diseases, the body mistakenly identifies its own tissues as an invader and attacks them until the organ is destroyed. ✦ This chronic attack eventually prevents the thyroid from releasing adequate levels of the hormones T3 and T4, which are necessary to keep the body functioning properly. Causes of Hypothyrodism ✦ can result from treatment of hyperactive thyroid. ✦ can be caused by changes in the structure or form of the thyroid. Signs and Symptoms of Hypothyrodism ✦ Fatigue/ Feeling tired ✦ Weakness ✦ Feeling cold/ greater sensitivity to cold ✦ Heart problems ✦ Unexplained increase in weight/ difficulty in losing weight ✦ Depressed feelings ✦ Hair loss ✦ Dry Hair ✦ Dry and rough pale skin Signs and Symptoms of Hypothyrodism ✦ Hoarse voice ✦ Muscle cramps and frequent muscle aches ✦ Bowel movement problems such as constipation ✦ Poor memory and concentration ✦ Poor hearing ✦ Slow pulse rate ✦ Shortness of Breath Hypothyrodism Treatments The easiest and most effective treatment is simply taking a Thyroid Hormone Pill (Levoothyroxine) once a day, preferably in the morning. ! This mediation is a sure synthetic form of T4 (thyroxin) which is made in a laboratory to exact replacement for the T4 that the human thyroid gland normally secretes. Hypothyrodism Complications A. Hypothyroidism— even in its mildest forms— can affect the health of your heart. ! ✦ An underactive thyroid can increase your risk of developing heart disease because it increases levels of "bad" cholesterol. Too much bad cholesterol can lead to atherosclerosis, hardening of the arteries, which can increase your risk of heart attacks and strokes. Hypothyrodism Complications A. Hypothyroidism— even in its mildest forms— can affect the health of your heart. ! ✦ Hypothyroidism can also result in the buildup of fluid around the heart, a pericardial effusion, which may make it harder for the heart to pump blood. Hypothyrodism Complications B. If thyroid hormone levels are too low, it can affect ovulation and decrease a woman's chances of conceiving. Even with proper treatment for hypothyroidism—thyroid hormone replacement therapy—there is no guarantee that the woman will be fully fertile. Hypothyrodism Complications ! C.The symptoms of hypothyroidism can take a mental toll if left untreated. Mild hypothyroidism can cause mild forms of depression. But without treatment, the symptoms of hypothyroidism will increase. This can directly affect your mental state, and your depression may intensify as a result What is Hyperthyrodism? ✦ also known as over active thyroid. ✦ it it is another thyroid condition that occurs due to excessive production of thyroid hormone (thyroxine (T4) and Triiodothyronine (T3) by the thyroid gland. Causes of Hyperthyrodism caused by Grave’s Disease an auto immune disease where your body produces antibodies to stimulate the thyroid gland which produces excessive thyroid hormone, more than the requirement for normal functioning of the body. Signs and Symptoms of Hyperthyrodism ✦ ✦ ✦ ✦ ✦ ✦ ✦ ✦ Muscle weakness / fatigue Weight loss High blood pressure Diarrhea Rapid heartbeat/heart palpitations Nervousness Irritability Anxiety Signs and Symptoms of Hyperthyrodism ✦ ✦ ✦ ✦ ✦ ✦ ✦ ✦ Hand tremors (shaky hands) Excessive sweating Difficulty/ trouble sleeping Skin dryness Skin thinning Rapid fingernail growth Double vision Increase frequency of bowel movements Diagnosis of Hyperthyrodism Hyperthyroidism is diagnosed based on symptoms: !✦ Physical exam ✦ Blood tests to measure levels of thyroid stimulating hormone (TSH) and thyroid hormones T3 and T4. Your doctor may also decide to order ✦ Either an ultrasound or a nuclear medicine scan of your thyroid to see if it has nodules, or whether it is inflamed or overactive. Treatment of Hyperthyrodism Hyperthyroidism usually is treated with medications, surgery, or oral radioactive iodine (to stop the function of thyroid cells) to reduce the production of excessive thyroid hormones. Treatment of Hyperthyrodism However, these treatments are imprecise and may cause the thyroid to secrete inadequate amounts of T3 and T4 and function insufficiently after treatment. Seventy percent to 90% of patients with Graves’ or thyroid cancer eventually need treatment for hypothyroidism as a result of treatment. What is Radioactive Iodine as one of the Hyperthyrodism Treatment? ✦ Taken by mouth, radioactive iodine is absorbed by your thyroid gland, where it causes the gland to shrink and symptoms to subside, usually within three to six months. What is Radioactive Iodine as one of the Hyperthyrodism Treatment? ✦ Because this treatment causes thyroid activity to slow considerably, causing the thyroid gland to be under active (hypothyrodism), you may eventually need to take medication very day to replace thyroxin. Side Effects of Radioactive Iodine Neck tenderness ✦ Nausea and vomiting ✦ Swelling and tenderness of the salivary glands ✦ Dry Mouth ✦ Taste Changes ✦ Hyperthyrodism Complications ✦ Arrhythmia (abnormal heart beat, such as atrial fibrillation) ✦ Cardiac Dilation (increase in the size of the heart cavities, which actually thins the heart muscle) ✦ Congestive Heart Failure Hyperthyrodism Complications ✦ Sudden Cardiac Arrest ✦ Hypertension ✦ Osteoporosis. You can gradually lose bone mineral density because uncontrolled hyperthyroidism can cause your body to pull calcium and phosphate out of the bones and to excrete too much calcium and phosphorous (through the urine and stool) What is Goiter? Goiter is a condition in which the thyroid gland grows larger/enlarged and there is visible swelling in the neck. The thyroid gland is a small, butterfly-shaped gland located in the neck, below the Adam's apple. Causes of Goiter ✦ Thyroid gland does not make enough hormones to meet the body's needs. The thyroid gland tries to make up for this shortage by growing larger.! ✦ Infection! ✦ Iodine Deficiency (not getting enough iodine from the diet) Causes of Goiter ✦ Other risk factors for causing Goiter include the following:! ! ✦ Hereditary (inherited from family)! ✦ Female gender! ✦ Age over 40 Causes of Goiter Other diseases and conditions can also cause a Goiter. These include:! !✦ Graves' disease is an autoimmune disease (your body's immune system mistakenly attacks your healthy body). In this case, the immune system attacks the thyroid gland and the thyroid grows larger. Causes of Goiter Other diseases and conditions can also cause a goiter. These include:! !✦ Hashimoto's Disease. This is another autoimmune disease. In this case, the disease causes inflammation (swelling) of the thyroid gland. This causes it to produce fewer thyroid hormones, resulting in a goiter. This type of goiter usually gets better on its own over time.! ✦ Nodular Goiter. In this condition, growths called nodules occur on one or both sides of the thyroid gland, causing it to grow larger. Causes of Goiter Other diseases and conditions can also cause a goiter. These include: ! !✦ Pregnancy. Human chorionic gonadotropin, a hormone that a woman produces during pregnancy, can cause the thyroid to grow.! ✦ Thyroiditis. Inflammation of the thyroid gland itself can the thyroid gland to grow. This can happen after the person has an illness caused by a virus, or after a woman gives birth. Causes of Goiter Other diseases and conditions can also cause a Goiter. These include:! !✦ Exposure to Radiation. A person who has had medical radiation treatments to the head and neck (but not diagnostic procedures, such as a CT scan) has a greater risk of developing goiter.! ✦ Thyroid Cancer. Cancer of the thyroid gland often enlarges the thyroid. Sign and Symptoms of Goiter The main symptoms of Goiter include: !✦ A swelling in the front of the neck, just below the Adam's apple ✦ A feeling of tightness in the throat area ✦ Hoarseness (scratchy voice) ✦ Neck vein swelling Sign and Symptoms of Goiter The Other, less common symptoms include: !✦ Difficulty breathing (shortness of breath) ✦ Coughing ✦ Wheezing (due to squeezing of the windpipe) ✦ Difficulty swallowing (due to squeezing of the esophagus, or “food tube”) Diagnosis of Goiter Several tests can be used to diagnose Goiter, including the following: !✦ Physical Exam – Your doctor may be able to tell if the thyroid gland has grown by feeling the neck area for nodules and signs of tenderness. !✦ Hormone Test – This blood test measures thyroid hormone levels, which tell if the thyroid is working properly. Diagnosis of Goiter Several tests can be used to diagnose Goiter, including the following: !✦ Antibody Test – This blood test looks for certain antibodies that are produced in some forms of goiter. An antibody is a protein made by white blood cells. Antibodies help defend against invaders (for example, viruses) that cause disease or infection in the body. Diagnosis of Goiter Several tests can be used to diagnose Goiter, including the following: ✦ Ultrasound of the Thyroid – Ultrasound is a procedure that sends high-frequency sound waves through body tissues. The echoes are recorded and transformed into video or photos. Ultrasound of the thyroid reveals the gland's size and can find nodules. !✦ CT Scan or MRI (magnetic resonance imaging) of the thyroid – If the goiter is very large or spreads into the chest, a CT scan or MRI is used to measure the size and spread of the goiter. Diagnosis of Goiter Several tests can be used to diagnose Goiter, including the following: !✦ Thyroid Scan – This imaging test provides information on the size and function of the gland. In this test, a small amount of radioactive material is injected into a vein to produce an image of the thyroid on a computer screen. This test is not ordered very often, since it is only useful in certain circumstances. Treatment of Goiter Treatment for goiter depends on how large the thyroid has grown, symptoms, and what caused it. Treatments include: !✦ No treatment/"watchful waiting." If the goiter is small and is not bothering you, your doctor may decide that it doesn’t need to be treated. However, the goiter will be closely watched for any changes. Treatment of Goiter Treatment for goiter depends on how large the thyroid has grown, symptoms, and what caused it. Treatments include: ✦ Medications. Levothyroxine (Levothroid®, Synthroid®) is a thyroid hormone replacement therapy. It is prescribed if the cause of the goiter is an underactive thyroid (hypothyroidism). Other medications are prescribed if the cause of the goiter is an overactive thyroid (hyperthyroidism). These drugs include methimazole (Tapazole®) and propylthiouracil. The doctor might prescribe aspirin or a corticosteroid medication if goiter is caused by inflammation. Treatment of Goiter Treatment for goiter depends on how large the thyroid has grown, symptoms, and what caused it. Treatments include: !✦ Radioactive Iodine Treatment. This treatment, used in cases of an overactive thyroid gland, involves taking radioactive iodine orally. The iodine goes to the thyroid gland and kills thyroid cells, which shrinks the gland. After radioactive iodine treatment, the patient usually has to take thyroid hormone replacement therapy for the rest of his or her life. Treatment of Goiter Treatment for Goiter depends on how large the thyroid has grown, symptoms, and what caused it. Treatments include: !✦ Biopsy. A biopsy is the removal of a sample of tissue or cells to be studied in a laboratory. A biopsy may be needed if there are large nodules in the thyroid gland. A biopsy is taken to rule out cancer. Treatment of Goiter Treatment for goiter depends on how large the thyroid has grown, symptoms, and what caused it. Treatments include: !✦ Surgery. Surgery is performed to remove all or part of the thyroid gland. Surgery may be needed if the goiter is large and causes problems with breathing and swallowing. Surgery is also sometimes used to remove nodules. Surgery must be done if cancer is present. Depending on the amount of thyroid gland removed, the patient may need to take thyroid hormone replacement therapy for the rest of his or her life.