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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...

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,...

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...

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Spontaneous abortion, stillbirth and hyperthyroidism: a danish population-based study.

Stine Linding Andersen¹, Jørn Olsen², Chun Sen Wu²

¹Department of Endocrinology, Aalborg University Hospital, Aarhus, Denmark ; Department of Clinical Medicine, Aalborg University, Aalborg, Aarhus, Denmark.

European Thyroid Journal

|December 25, 2014

Summary

Maternal hyperthyroidism increases the risk of pregnancy loss, including spontaneous abortion and stillbirth. Prompt diagnosis and treatment of thyroid dysfunction are crucial for improving pregnancy outcomes.

Keywords:

Antithyroid drug Graves' disease Hyperthyroidism Pregnancy Pregnancy loss Spontaneous abortion Stillbirth

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Area of Science:

Reproductive Endocrinology
Maternal-Fetal Medicine
Thyroidology

Background:

Pregnancy loss is a significant concern in women with hyperthyroidism, though population-level risks remain unclear.
Existing data primarily consists of case reports, necessitating population-based studies to quantify the association.

Purpose of the Study:

To evaluate the association between maternal hyperthyroidism and the risk of pregnancy loss.
To differentiate risks for early (spontaneous abortion) and late (stillbirth) pregnancy loss.

Main Methods:

A nationwide population-based cohort study in Denmark (1997-2008) included over 1 million pregnancies.
Maternal hyperthyroidism was identified via hospital diagnosis or antithyroid drug (ATD) prescription.
Cox proportional hazards models estimated adjusted hazard ratios (aHR) for spontaneous abortion and stillbirth.

Main Results:

Maternal hyperthyroidism diagnosed before or during pregnancy was associated with increased spontaneous abortion risk (aHR 1.28-1.18).
Hyperthyroidism diagnosed postpartum was linked to a significantly higher risk of stillbirth (aHR 2.12).

Conclusions:

Both early and late pregnancy losses are more frequent in women with hyperthyroidism.
Inadequately treated hyperthyroidism in early pregnancy may contribute to spontaneous abortion.
Undetected maternal thyroid dysfunction in late pregnancy may increase stillbirth risk.