Download MBBS Hypothyroidism Lecture PPT

HYPOTHYROID.
Thyroid gland.

?Thyroid is a small gland found in the middle of the

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lower neck.

?Thyroid works with pituitary gland which

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produces thyroid stimulating hormone(TSH).

?TSH stimulate the thyroid gland to produce the

thyroid hormone,T3 and T4.

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Thyroxine Hormone

vIodine, a trace mineral, is essential for the

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synthesis of thyroid hormone..

vThyroxine(T4) and triiodothyronine (T3).

v20 % of T3 derived directly from thyroid gland

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and 80 % by conversion from T4.

vThyroid hormone regulate metabolism in every

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cell of the body and play a role in virtually all

physiological function.
Regulating thyroid hormone.

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o When the amount of thyroid hormone in the blood

drops, the pituitary gland secretes a hormone called

thyroid stimulating hormone(TSH).

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o TSH then stimulate the thyroid gland to increase its

uptake of iodine from the blood, so that more

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thyroxin(T4) can be synthesized.

o When necessary, thyroid is then converted to the

metabolically active triodothyroxine(T3), a process that

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involves removing one iodine atom from T4.
TSH: THYROID STIMULATING

HORMONE.

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?ELEVATED TSH.
?> 5mU/L

?LOW TSH.

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HYPERTHYROIDISM ?< 0.5mU/L.
.

TEST

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FROM

TO

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UNITS

TSH

0.25

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5.00

mU/L

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FT4

9.0

25.0

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pmol/L

FT3

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3.5

7.8

pmol/L

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THYROID TEST

? TSH--NORMAL RANGE--0.25--5.0 mU/L.

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? Symptomatic primary hypothyroidism > 20
? Mild symptomatic hypothyroidism 10 to 20
? Primary hyperthyroidism < 0.05.
? Thyroxine(T4)

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? Triiodothyronine(T3)
? Free T3
? Free T4
Labs.

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Hyperthyroidism

? FT4
? TSH

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Hypothyroidism

? FT4
? TSH.
Labs.

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TSH

HIGH-TSH

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LOW

FT4- LOW

HYPOTHYROIDISM

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FT4 AND FT3-LOW

HIGH-FT4 AND

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CENTRAL

FT3

HYPOTHYROIDISM.

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HYPOTHYROID

THYROTOXICOSIS.
WHEN TO HAVE THYROID

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FUNCTION TEST.

? Swelling in the neck
? Abnormal menstrual cycle

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? Fertility problem
? High cholesterol
? Weight gain
? Puffiness of Face, dry skin, hair loss
? Fatigue, lethargy, Anemia etc..

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THYROID REGULATION.
Physiological actions of Thyroxin

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hormones.

? Potentiates brain development.
? Increases heart rate.
? Increases cardiac output.

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? Increases ventilation rate.
? Thickens of endometrium in female.
Metabolic effects of Thyroid

hormones.

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vThe hormone exerts action on every cell on

the body.

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vCalorigenic effect or thermogenesis is the

major effect of throid hormone.

vThis thermogenic effect is mediated by

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uncoupling of oxidative phosphorylation.
vBasal metabolic rate (BMR) is increased.

vThyroxine increases cellular metabolism.

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vEarliest effect of T4 is stimulation of RNA

synthesis and consequent increase in protein
vsynthesis Higher concentration of T3 causes

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protein catabolism and negative nitrogen

balance.

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vLoss of body weight is a prominent feature of

hyperthyroidism.
vGluconeogenesis and carbohydrate oxidation

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are increased.

vGlucose tolerance test shows rapid absorption.
vFatty acid metabolism is increased.

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vCholesterol degradation is increased and
hence cholesterol level in blood is decreased,
which is another hallmark of hyperthyroidism.

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CAUSE OF HYPOTHYROIDISM.
hypothyroidism.

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? Hypothyroidism is a thyroid problem caused

by an underactive thyroid gland that produces

insufficient amount of thyroid hormones.

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? Hypothyroidism is seen in both sexes, but is

more common in women.

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? In pregnancy new born is at risk of cretinism.
? Cold intolerance
? Constipation.
? Lethargy
? Dry and course skin and hair

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? Facial puffiness
? Anemia
? Impaired memory
? Confusion
? Dementia

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? Low speech and motor activity.



Complications.

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? Untreated condition, patient is at risk for?
? Diabetes.
? High blood pressure.
? Arthritis.

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? Depression.
? Recurrent infection.
? Migraine.
Classification of hypothyroidism.

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Due to failure

Due to

Due to failure

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of the thyroid

hypopituitarism.

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of

gland itself.

hypothalmus.

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PRIMARY.

TERTIARY.

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SECONDARY.
Hypothyroidism(GOITRE).

? Excess stimulation by TSH due to decreased

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level of circulating thyroid hormones, leads to

enlargement of thyroid gland.

? Reason:

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? 1. Iodine deficiency.
? 2.certain antithyroid drugs.
? 3.Hashimoto's thyroiditis.