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 • 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. • The gland produces the hormones thyroxine and triiodothyronine , they control how the body uses energy. This process is called your metabolism. • Hyperthyroidism occurs when the thyroid releases too much of its hormones over a short (acute) or long (chronic) period of time. • • • • • • • 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 • • • • • • • • • • • • 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 • • Signs and tests Tests may reveal thyroid enlargement, tremors, hyperactive reflexes, or an increased heart rate. • Also- Systolic blood pressure (the first number in a blood pressure reading) may be high. • Subclinical hyperthyroidism (mild form of hyperthyroidism) is diagnosed by abnormal blood levels of thyroid hormones. • Blood tests are also done to measure levels of thyroid hormones. • When testing and diagnosed the TSH (thyroid stimulating hormone) level is usually low • And T3 and free T4 levels are usually high Treatment • Treatment depends on the cause or the severity of symptoms. • Hyperthyroidism treatment includes: • Antithyroid medications (prevent the thyroid from producing excess amounts of hormone) • Radioactive iodine (destroys the thyroid and stops the excess production of hormones) • Surgery to remove the thyroid • 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. • 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.