Postpartum Thyroiditis : The Thyroid Gland

of Thyroxine to T3 in the tissues). After 2 months of treatment, her TSH levels increased by 371.15% and her Thyroxine levels

Thyrotoxicosis is a clinical condition caused by excess circulating serum thyroxine (T4), triiodothyronine (T3), or both with suppression of thyroid-stimulating hormone (TSH). A negative feedback loop involving the hypothalamus, pituitary, and thyroid gland regulates the production and release of thyroid hormones. (Fig. 1) The hypothalamus releases thyroid-releasing hormone (TRH), stimulating the pituitary gland to release TSH, in turn stimulating the thyroid gland to release T4 and T3. Enhanced production of T4 and T3

In order to evaluate thyroid function and diagnose thyroid diseases such as hyperthyroidism or hypothyroidism, the free thyroxine (free T4) lab test is performed usually after discovering that the thyroid stimulating hormone (TSH) level is abnormal (Porth C 2014 p.1288)

Most T3 and T4 released into the bloodstream are bound to proteins. Only the "free" component is biologically active and it is this component which decides the manifestations of thyrotoxicosis. The hormones exert their effects mainly by binding to nuclear receptors in cells to affect expression of genes.

Incidentally, there are actually two compounds made in the thyroid that are called thyroid hormone. The most abundant is T4, also known as thyroxine, which is then converted to T3, or triiodothyronine. T3 is the active form that produces the effects on metabolism.

To get a diagnosis, a provider will assess a patients symptoms and if they are indicative of hypothyroidism, blood and antibody tests would be taken (Mayo Clinic Staff, 2016). These tests indicate the amount of thyroid hormone and thyroid-stimulating hormone (TSH) produced in the pituitary gland (Mayo Clinic Staff, 2016). The results will represent the fact that the immune system is producing antibodies toward proteins in the thyroid gland which is causing an inability to produce thyroid hormones (Burkhart,

Correct Predictions: TSH levels in patients with primary hypothyroidism are high Thyroxine (T4) levels in patients with primary hypothyroidism

Karen Holt describes in her 2010 article Graves’ Disease: Clinical Pathophysiology, Presentation and Treatment Options of certain genetic markers that cause the blood vessels surrounding the thyroid gland to dilate, most often occurring in the second to third decade of life. The dilation of these vessels causes an increase in blood flow and thyroid-stimulating antibodies excite thyrotropin receptors on the gland itself in the same manner that TSH usually works. These antibodies, known as TSAb, bypass the negative feedback loop that TSH works under causing the follicles to produce thyroid hormones in copious amounts without the ability to turn themselves “off”. This in turn causes the thyroid gland to hypertrophy and grow as much as 2 to 3 times its normal size (p. 13-14). In an effort to stop the overproduction of thyroid hormones the pituitary gland will stop making TSH and this becomes part of the diagnosing for Graves’ disease when assessing hyperthyroidism. Increased levels of free T3 and T4 along with an almost non-detectable level of TSH in a blood screen are very indicative of Graves’ disease (Holt, 2010, p. 14). There is no cure for Graves’ disease, but it is treatable with lifestyle adjustments as well as drug therapy it can be managed to a point (p 46).

Thyroxine (T4) is the key hormone produced in the thyroid gland. Low levels of T4 produce hypothyroidism, and high levels produce hyperthyroidism. Thyroxine converts to triiodothyronine (T3), which is a more biologically active hormone. Only about 20% of triiodothyronine is actually formed in the thyroid gland. The rest is manufactured from circulating thyroxine in tissues outside the thyroid, such as those in the liver and kidney. Once Thyroxine (T4) and Triiodothyronine are in circulation, they typically bind to substances called thyroid hormone transport proteins, after which they become inactive. The follicular cells of the thyroid gland perform all the necessary functions required to make and secrete the thyroid hormones.

The thyroid gland is the gland that makes and stores hormones that help regulate the heart rate, blood pressure, body temperature, and metabolism. Thyroid hormones are essential for the function of every cell in the body. They help regulate growth and the rate of chemical reactions in the body. Thyroid hormones also help children grow and develop. The thyroid gland is located in the lower part of the neck, below the Adam's apple, wrapped around the trachea. It has the shape of a butterfly with two lobes attached to one another by a middle part called the isthmus. The thyroid uses iodine, a mineral found in some foods and in iodized salt, to make its hormones. The two most important thyroid hormones are thyroxine (T4) and triiodothyronine

The thyroid gland is found in the front of the neck and produces two main hormones. The hormones are called thuroxine (T4) and Triiodothyronine (T3). Together these hormones regulate the body’s metabolism by increasing energy use in cells, regulate growth and development, help to maintain body temperature and aid in oxygen consumption. These two hormones are regulated by hormones produced by the hypothalamus and pituitary gland. The hypothalamus senses changes in body’s metabolic rate and releases a hormone known as thyropin-releasing hormone (TRH). This hormone then flows through connecting vessels to the pituitary gland which signals it to release another hormone. This hormone is known as thyroid-stimulating hormone (TSH). TSH then makes

These hormones have a critical role in cell differentiation during development and help maintain thermogenic and metabolic homeostasis in the adults.12 Thyroid disorders are highly prevalent in the population and mostly affect women in childbearing age.13 In pregnancy, thyroid gland displays mild to moderate enlargement because of increased physiological demands. Thyroid function is altered by 4 factors in pregnancy: i) the transient increase in human chorionic gonadotropin (hCG) during the first trimester, which cross-reacts with thyroid-stimulating hormone (TSH) receptor; ii) the estrogen-induced rise in thyroxine-binding globulin (TBG) which is the major transport protein for thyroid hormone; iii) increased autoimmunity; and iv) increased urinary iodide clearance, which can cause impaired thyroid hormone production in areas of low iodine supply.12,14-17 Consequently, the levels of both T3 and T4, the major hormones released by the thyroid, increase by ~50% and serum TSH levels decrease in the first trimester and increase in the second and third

Total T4 and free T4 are two separate tests that can help a doctor evaluate thyroid function. The total T4 test has been used for many years to help diagnose hyperthyroidism and hypothyroidism. It is a useful test but can be affected by the amount of protein available in the blood to bind to the hormone. The free T4 test is a newer test that is not affected by protein levels. Since free T4 is the active form of thyroxine, the free T4 test is thought by many to be a more accurate reflection of thyroid hormone function and, in most cases, its use has replaced that of the total T4 test. Whichever thyroxine measurement is ordered, it is usually ordered along with or following a TSH test. This helps the doctor to determine whether the thyroid hormone feedback system is functioning as it should, and the results of the tests help to distinguish between different causes of hyperthyroidism and hypothyroidism. Sometimes a T3 test will also be ordered to give the doctor additional diagnostic information. A T4 and TSH test may be ordered to help evaluate a person with a goiter and to aid in the diagnosis of female infertility. If a doctor suspects that someone may

We agree that the answer to this question is A: increased TSH. In most patients, hypothyroidism is a result of abnormal development of the thyroid gland (Congenital Hypothyroidism, 2015). This abnormal development poses the largest threat when T4 levels are decreased. Decreased T4 values trigger the pituitary gland to respond by producing thyroid stimulating hormone (TSH). Because the thyroid gland is malformed, the low T4 levels cause the pituitary gland to continually receive signals from the hypothalamus that more TSH needs to be produced. In conclusion, when lab results display a low T4 level and an elevated TSH level, the suspicion of hypothyroidism is confirmed.

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