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Hyperthyroidism I: Introduction

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...

Hyperthyroidism II: Pathophysiology

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...

Hypothyroidism II: Pathophysiology

Hypothyroidism II: Pathophysiology

Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...

Synthesis and Regulation of Thyroid Hormones

Synthesis and Regulation of Thyroid Hormones

Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...

Graves' Disease I: Introduction

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence...

Graves Disease II: Pathophysiology

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor,...

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Mixed Reality Assisted Radical Endoscopic Thyroidectomy

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Interventions for hyperthyroidism pre-pregnancy and during pregnancy.

Rachel Earl¹, Caroline A Crowther, Philippa Middleton

¹Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The University of Adelaide, Medical School North Building, Frome Road, Adelaide, Australia, 5005.

The Cochrane Database of Systematic Reviews

|November 20, 2013

Summary

No eligible trials were found for managing hyperthyroidism in pregnancy. Further research is needed due to challenges in studying antithyroid interventions and potential drug risks.

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Area of Science:

Obstetrics and Gynecology
Endocrinology

Background:

Hyperthyroidism in pregnancy increases risks of miscarriage, stillbirth, preterm birth, intrauterine growth restriction, pre-eclampsia, and placental abruption.
Effective management strategies for pregnant women with hyperthyroidism are crucial.

Purpose of the Study:

To identify interventions for managing hyperthyroidism pre-pregnancy or during pregnancy.
To assess the impact of these interventions on maternal, fetal, neonatal, and childhood outcomes.

Main Methods:

A systematic search of the Cochrane Pregnancy and Childbirth Group's Trials Register was conducted.
Planned inclusion of randomized controlled trials, quasi-randomized controlled trials, and cluster-randomized trials comparing antithyroid interventions.

Main Results:

No eligible trials were identified for inclusion in this review.
The review could not provide evidence-based recommendations due to the lack of studies.

Conclusions:

Designing trials for antithyroid interventions in pregnancy is challenging due to the rarity of hyperthyroidism and potential drug harms.
Further observational research is needed on the risks of methimazole and propylthiouracil during pregnancy.