Disorders Of Endocrine Control Of Growth And Metabolism

Laboratory Report/ Miranda Tefft/ Homeostatic Imbalances of Thyroid Function/ Aline Potvin/ 11.18.2014/ Page [2] of [3]

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pituitary is not creating as much TSH. This would cause the Thyroid to stop producing T4

Diagnosis: patients who present with signs and symptoms of hypothyroidism, such as low energy, weight gain, cold intolerance, and amenorrhea, should be tested for the disorder with serum measurements of TSH and free T4. High TSH and low free T4 levels suggest hypothyroidism. Conversely, measurement of anti-thyroid antibodies may also be tested, such as anti-thyroglobulin, anti-thyroid peroxidase, and anti-TSH receptor. Clinical suspicion should still be present when patients do not have these characteristic hypothyroid symptoms, but present with primary amenorrhea in the

According to Edmunds & Mayhew (2014), T 3, T4, and TSH should be obtained after 3 to six weeks after initial therapy. Other literature recommends monthly lab work during the initial therapy and until euthyroid state has been achieved. Due to the risk of relapse it is also recommended to monitor thyroid function every 3 months for the first year after euthyroid state (Reid, & Wheele, 2015).

TSH not only stimulates the thyroid gland to churn out more hormones. If in excess, can cause overwhelming cell growth and division to result in goiter.

A goiter, nodules, or growths may be found during a physical exam, and symptoms may suggest hypothyroidism.

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,

The patient’s diagnosis is primary overt hypothyroidism. The patient presents with certain features such as weight gain, weakness, excessively dry flaking skin, dry hair, sluggish movements, constipation, bradycardia, diminished deep tendon reflexes, and bilateral edematous hands, which is classical signs and symptoms for primary hypothyroidism. The patient laboratory test reveals she has an elevation in serum thyroid stimulating hormone level along with low serum free thyroxin and triiodthyronine levels, which indicates it is a dysfunction or abnormality in the thyroid gland as opposed to the pituitary gland or hypothalamus (Gaitonde; Lohano; Porth, 2015, p. 780; Ross, 2014).

Some of these diagnoses include a physical exam, blood sample, radioactive iodine uptake and ultrasound1. With a physical exam, the doctor will check the patient’s eyes to see if they are bulging out or the area around the eye looks enlarged. They well check to see if the thyroid gland is abnormally large and because of its association with increase metabolism, the doctor will check the pulse and blood pressure of the patient and look for signs of tremors which are involuntary quivering movements1. Only in severe cases will a blood test detect TSI in the bloodstream, if TSI does not show up in a patient’s blood, then a radioactive iodine may be conducted. This is because the thyroid intakes iodine from the bloodstream and uses that iodine in order to make thyroid hormones so the radioactive iodine is inserted in the bloodstream and is collected by the thyroid gland, is the thyroid gland collects large amounts of this radioactive iodine, then the patient may have Graves’ disease3. If the patient is pregnant, that patient cannot undergo radioactive treatment because the radioactive iodine could harm the fetus’ thyroid and can be passed from the mother to the child in breast milk if the mother is breastfeeding4. An ultrasound can use the high-frequency waves to produce images of structures inside the body and can show if the thyroid gland is enlarged or

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

A lot of the conditions discussed above can be treated, or even prevented, if regular tests are done to monitor the gland. Some of the routine tests that health care providers can use to check the functionality of the gland are TSH test, T4 tests, T3 test, thyroid-stimulating immunoglobulin (TSI) test, and the antithyroid antibody test (also called the thyroid peroxidase antibody test (TPOab)). All of these tests are blood tests and depending on if the patient is showing any symptoms of thyroid dysfunction, the health care provider may order more than one of these tests to be

As the most interesting patient presentation, two weeks ago there was a 50-year-old Hispanic woman who came to the clinic and complained of unintentional weight gain over 28 pounds in the last two years. The patient wanted to participate in the weight loss program. Upon the physical assessment, this patient stated that her family runs thyroid disorder issues. Prior to starting the weight loss management, my preceptor and I decided to run some lab works to assess her TSH, Free T4, T3, and some other test. The patient has a follow-up appointment in the following week for her lab result. The patient lab’s result abnormal thyroid hormones. She had hypothyroidism. She stated that she had a primary physician that she had seen over 10 years, and they never told her about this problem. The plan was to treat the thyroid problem by prescribing her Armour Thyroid starting at 30 mg. According to Woo and Wynne (2015), for patients who are clinically hypothyroid, replacement therapy with thyroid hormones is

According to The National Institute of Diabetes and Digestive and Kidney Diseases, diagnosis of Hashimoto’s thyroiditis begins with a physical exam and medical history. A goiter, nodules, or growths may be found during a physical exam, and symptoms may suggest hypothyroidism. Health care providers will then perform blood tests to confirm the diagnosis. Diagnostic blood tests may include the TSH, which, if above normal lab values, means a patient has hypothyroidism. Blood tests also include T4, which is the amount of thyroid hormone in the blood. In hypothyroidism, the blood lab values are lower than normal. The anti-thyroid antibody tests look for presence of thyroid autoantibodies. Most people with Hashimoto’s disease have these antibodies; however, hypothyroidism isn’t always caused