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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...

The Thyroid Gland

The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...

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...

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 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,...

Goiter

Goiter

Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...

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Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

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Published on: May 12, 2023

Obstetric controversies in thyroidology.

Ambika Gopalakrishnan Unnikrishnan¹, Shilpa Bhosale, Sanjay Kalra

¹Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, India.

Indian Journal of Endocrinology and Metabolism

|November 20, 2013

Summary

Thyroid disease in pregnancy presents challenges, particularly hypothyroidism linked to adverse outcomes. This review examines thyroid hormone deficiency

Area of Science:

Endocrinology
Obstetrics
Maternal-Fetal Medicine

Background:

Thyroid disorders are prevalent in women and pose significant challenges during pregnancy.
Maternal hypothyroidism and hypothyroxinemia are associated with adverse feto-maternal outcomes.
Managing thyroid dysfunction in pregnant individuals requires careful consideration by endocrinologists.

Purpose of the Study:

To discuss the controversy surrounding first-trimester thyroid hormone deficiency and its impact on fetal brain development.
To review obstetric controversies in managing hyperthyroidism during pregnancy.
To explore indications for TSH receptor antibody measurements and fetal thyroid monitoring.

Main Methods:

Literature review of current research on thyroid disorders in pregnancy.

Keywords:

Hypothyroidism hyperthyroidism pregnancy

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Discussion of clinical controversies and management strategies.

Analysis of feto-maternal outcomes related to maternal thyroid status.

Main Results:

Maternal thyroid hormone deficiency in early pregnancy is a concern for fetal neurodevelopment.
Management of hyperthyroidism in pregnancy involves specific considerations regarding antibody measurements and fetal monitoring.
Evidence synthesis on the link between maternal thyroid status and pregnancy outcomes.

Conclusions:

Addressing thyroid dysfunction in pregnancy is crucial for optimizing maternal and fetal health.
Further research is needed to clarify the precise impact of thyroid hormone levels on fetal development.
Standardized guidelines for managing thyroid disease in pregnant women are essential.