The Treatment Goal Of 75 Year Old Male With Hypothyroidism

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2. The subject who was diagnosed with secondary hypothyroidism was given levothyroxine (synthetic Thyroxine). After 6 weeks of

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

The main treatment for hypothyroidism is synthetic thyroid hormone in pill form to replace what’s missing. Depending on the reason for the slow thyroid, adding more iodine to the diet and generally eating a healthy diet can help.

Background: An 83 year old female is taking her levothyroxine medication to help treat her thyroid disorder induced by Hashimoto. She has been taking this medication for thirty years. While always being adherent to taking her medication, she has never really understood what Hashimoto thyroiditis actually is, or why levothyroxine is the best choice of therapy for treating her hypothyroidism caused by the disease. She is also positive for hypertension, GERD, and insomnia.

Hypothyroidism is caused by the thyroid’s gland inability to produce thyroid hormone as required by the body. The diagnosis of hypothyroidism requires the laboratory testing of the thyroid stimulating hormone known as TSH. When the TSH is found to be elevated, a clinician should repeat the test along with a free thyroxine (T4) measurement. If the TSH is found to be elevated, while the T4 is normal, the patient is said to suffer from subclinical hypothyroidism. However, if the TSH is elevated and the T4 is low, the diagnosis is primary hypothyroidism (Gaitonde et al., 2012).

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

Based on the levothyroxine dosing guidelines for hypothyroidism in adults, the patient’s initial starting dose would be 100 micrograms per day. The patient is instructed to take the medication once daily wither thirty minutes before eating in the morning or at bedtime or two hours post last meal ate. The patient is advised not to take calcium or iron supplements within four hours of taking levothyroxine because it can alter the absorption of thyroid hormone. The patient should start feeling better within two to three weeks of starting the levothyroxine, if not she is advised to contact the clinic for a reevaluation. The patient will have a scheduled reevaluation appointment along with laboratory work (redraw of TSH) in six weeks. Depending on the patient’s reevaluation laboratory work and presenting condition, there will be additional adjustments to the medication regimen followed by another six-week reevaluation or she will have a six-month reevaluation to assure proper maintenance dose has been achieved. The patient is advised that if there is any change in patient’s status as far as weight loss/gain, pregnancy, surgery, or new additional medications that may alter the thyroid hormone level, there will be a need to reassess plan of care (Danzi; Garber; Ross,

The first (1st) is by prescribing antithyroid medications which help the thyroid from producing too much of the thyroid hormone. The second (2nd) treatment that is recommended is radioactive iodine. This treatment is in pill form that damages the thyroid by giving it radiation. Even in this case, you will most likely end up having to take thyroid medications for the rest of your life. The third (3rd) and last treatment is surgery. This is when they completely remove all of your thyroid which cures the overactive thyroid but in addition from having it removed, you have to take a thyroid hormone to replace what has been removed. Aside from these treatment plans, your doctor may prescribe you a drug called beta-blocker which slows down your heart rate and reduces symptoms of shaking and nervousness. This drug works quickly and helps make you feel better while it takes

Thyroid hormone deficiency in the body is risky to the malfunction of the vital organs. Alterations like lowering and slowing of the biological processes in the body are assumed by the illness. These variations may replicate those that come about with age. The symptoms associated with hypothyroidism may be difficult to describe especially in the old persons. Hypothyroidism can show different manifestations and signs, depending on the health condition, age and sex of the patient. Thus, for it to be treated appropriately, the nursing practitioner has to have the correct diagnosis (Garber, 2012). Since the disorder is more evident at old age, it is, therefore, vital for thyroid disorder among the aged to be a matter of discussion (Laurberg, 2005). Thus, this thesis aims at discussing the effects of hypothyroidism to a seventy years old male

a.ii.1. A person that decides not to get treatment can go through a thyroid storm, which is rare but dangerous to a person

The thyroid stimulating hormone receptors are G-protein linked and are found extracellularly in the thyroid glands. When activated, synthesis of hormonally active iodothyronines T3 (triiodothyronine) and T4 (thyroxine) begins (Park and Chatterjee, 2005). This process begins with iodide is transported into the thyroid gland by the sodium iodide symporter found in the membrane of thyroid follicular cells (Park and Chatterjee, 2005). The iodotyrosine residues monoiodotyrosine and diiodotyrosine are then formed through iodine organification where the iodide is oxidised using hydrogen peroxide and then bound to tyrosine in the thyroglobulin (Park and Chatterjee, 2005). The residues then bind together to form the hormonally active iodothyronines aforementioned (Park and Chatterjee, 2005). Many catalytic enzymes mediate this process and are needed to ensure proper thyroid hormone synthesis. Failure in any steps of the synthesis process leads dyshormonogenesis and could be the result of genetic defects. Adequate synthesis of active thyroid hormone is necessary for the regulation of many developmental processes (Richter, C. et al.,

Levothyroxine is a synthetic form of T4. It is the most commonly used drug of for replacement therapy in patients with low thyroid function. The main actions of the drug are similar to the natural form of the thyroid hormone and include weight loss, tolerance to environmental temperature, increased activity and a faster heart rate. The drug is taken typically orally, and has to be used for life to maintain the proper hormone level. Overdosing is a common issue and patients often return to their physician within four to six weeks to reevaluate the proper dosage levels.

Levothyroxine is a thyroid hormone replacement medication. Taking thyroid pills is the only way to treat hypothyroidism. I do not think there are any alternatives to it.

Consultation. Although most primary care providers can diagnose and treat hypothyroidism, consultation with an endocrinologist is recommended in certain situations; Children and infants, Patients in whom it is difficult to render and maintain a euthyroid state, Pregnancy, Women planning conception, Cardiac disease, Presence of goiter, nodule, or other structural changes in the thyroid gland, Presence of other endocrine disease such as adrenal and pituitary disorders. Endocrinologists are more knowledgeable about thyroid disease than primary care providers; therefore it is necessary to refer the patient in challenging clinical situations as listed (Garber, 2012).