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Related Concept Videos

Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

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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...
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Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

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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...
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Hypothyroidism II: Pathophysiology01:23

Hypothyroidism II: Pathophysiology

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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...
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Functions of Thyroid Hormones01:18

Functions of Thyroid Hormones

7.1K
The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
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Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

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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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Synthesis and Regulation of Thyroid Hormones01:20

Synthesis and Regulation of Thyroid Hormones

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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...
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Author Spotlight: In Vivo Assessment of Thyroid Hormone Disruption Using the THAI Mouse Model
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Thyroid function in the euthyroid range and adverse outcomes in older adults.

Anne R Cappola1, Alice M Arnold, Kendra Wulczyn

  • 1Division of Endocrinology, Diabetes and Metabolism (A.R.C., K.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104; Department of Biostatistics (A.M.A.), University of Washington, Seattle, Washington ; Department of Mental Health (M.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205; Division of General Medicine (J.R.), University of California, Davis, Sacramento, California 95817; Cardiovascular Health Research Unit (B.M.P.), Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle, Washington 98101; and Group Health Research Institute (B.M.P.), Group Health Cooperative, Seattle, Washington 98101.

The Journal of Clinical Endocrinology and Metabolism
|December 17, 2014
PubMed
Summary

Thyroid function tests in older adults show that higher TSH and lower FT4 within the normal range are linked to fewer adverse events. This suggests current thyroid treatment thresholds may need re-evaluation for this population.

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Author Spotlight: In Vivo Assessment of Thyroid Hormone Disruption Using the THAI Mouse Model
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Author Spotlight: In Vivo Assessment of Thyroid Hormone Disruption Using the THAI Mouse Model

Published on: October 6, 2023

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Area of Science:

  • Gerontology
  • Endocrinology
  • Cardiovascular Medicine

Background:

  • Current thyroid function test reference ranges in older adults are debated.
  • The study questions the appropriateness of established thyroid hormone level guidelines for the elderly.

Purpose of the Study:

  • To investigate the association between thyroid function tests (TSH, FT4, T3) within the euthyroid range and adverse health outcomes in older adults.
  • To determine if current reference ranges for thyroid function are suitable for predicting adverse events in the elderly.

Main Methods:

  • Analysis of data from 2843 community-dwelling older adults in the Cardiovascular Health Study.
  • Measurement of TSH, free T4 (FT4), and total T3 concentrations.
  • Assessment of the incidence of atrial fibrillation, coronary heart disease, heart failure, hip fracture, dementia, and all-cause mortality.

Main Results:

  • Higher TSH levels within the euthyroid range were associated with reduced mortality and dementia risk.
  • Higher FT4 levels were linked to increased risks of atrial fibrillation, heart failure, coronary heart disease, and mortality.
  • Total T3 levels showed no significant association with any measured adverse outcomes.

Conclusions:

  • Within the euthyroid range, higher TSH and lower FT4 concentrations correlate with a lower risk of adverse events in older individuals.
  • Findings suggest a potential tolerance for lower thyroid hormone levels in the elderly, challenging current treatment guidelines.
  • Further clinical trials are recommended to assess new treatment thresholds and optimal thyroid hormone replacement targets for older adults.