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Related Concept Videos

Hypothyroidism II: Pathophysiology01:23

Hypothyroidism II: Pathophysiology

26
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...
26
Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

30
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...
30
Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

28
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...
28
Graves' Disease I: Introduction01:28

Graves' Disease I: Introduction

23
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...
23
Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

26
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,...
26
Synthesis and Regulation of Thyroid Hormones01:20

Synthesis and Regulation of Thyroid Hormones

7.1K
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...
7.1K

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Hypothyroidism in pregnancy.

Weiping Teng1, Zhongyan Shan1, Komal Patil-Sisodia2

  • 1Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China.

The Lancet. Diabetes & Endocrinology
|March 14, 2014
PubMed
Summary
This summary is machine-generated.

Hypothyroidism affects 3-5% of pregnant women. Treatment is recommended for overt hypothyroidism, but therapy for subclinical hypothyroidism lacks consistent evidence, so universal screening is not advised.

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Area of Science:

  • Endocrinology
  • Reproductive Medicine
  • Maternal-Fetal Medicine

Background:

  • Hypothyroidism is the most common pregnancy-related thyroid disorder, impacting 3-5% of expectant mothers.
  • Subclinical hypothyroidism, characterized by elevated thyroid-stimulating hormone (TSH), is more prevalent than overt hypothyroidism during pregnancy.

Purpose of the Study:

  • To review current understanding and management of hypothyroidism in pregnancy.
  • To discuss diagnostic criteria for subclinical and overt hypothyroidism.
  • To evaluate the evidence for treating subclinical hypothyroidism and the rationale behind screening recommendations.

Main Methods:

  • Review of existing literature and professional guidelines on thyroid disorders in pregnancy.
  • Analysis of diagnostic criteria for hypothyroidism based on serum TSH levels.
  • Discussion of treatment protocols for overt and subclinical hypothyroidism.

Main Results:

  • Overt hypothyroidism requires prompt levothyroxine treatment to normalize TSH levels.
  • Recommendations for treating subclinical hypothyroidism vary due to inconsistent clinical trial and observational study data.
  • Most professional groups do not recommend universal screening for subclinical hypothyroidism or thyroid autoimmunity in pregnancy due to uncertain therapeutic benefits.

Conclusions:

  • Levothyroxine dose adjustment is necessary in over 50% of pregnant women with pre-existing hypothyroidism.
  • The management of hypothyroidism during pregnancy requires careful consideration of TSH levels and available evidence.
  • Further research is needed to clarify the benefits of treating subclinical hypothyroidism in pregnancy.