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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 iodine is then...

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 receptors...

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 in...

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, and heat...

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...

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Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

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Thyroid Storm: A Case Report.

Carolina António Santos¹, Ana Filipa Vassalo², José Rocha³

¹Internal Medicine, Unidade Local de Saúde Santa Maria, Lisbon, PRT.

|June 24, 2025

Summary

This summary is machine-generated.

Thyroid storm, a severe hyperthyroidism complication, can cause multiorgan dysfunction. Prompt diagnosis and tailored therapies, including antithyroid drugs and corticosteroids, are crucial for recovery from this rare Graves

Keywords:

anemia graves´ disease heart failure liver failure thyroid storm

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Area of Science:

Endocrinology
Internal Medicine

Background:

Thyroid storm is a life-threatening exacerbation of hyperthyroidism, often linked to Graves' disease.
Triggering factors include medication non-adherence, infections, and surgical stress.
Multiorgan dysfunction, especially hepatic and cardiovascular, is a common severe complication.

Observation:

A case of long-standing Graves' disease presented with a diagnostic challenge of thyroid storm.
The patient exhibited multiorgan dysfunction, scoring 45 on the Burch-Wartofsky point scale.
This severe presentation required intensive and individualized management.

Findings:

Effective management involved a combination of synthetic antithyroid drugs, beta-blockers, and corticosteroids.
Supportive therapies were essential to address the affected organ systems.
The patient eventually achieved a euthyroid state with complete resolution of symptoms.

Implications:

Highlights the critical need for prompt diagnosis and aggressive, multimodal treatment in thyroid storm.
Emphasizes the importance of individualized therapy selection based on patient presentation and organ involvement.
Demonstrates that even severe cases of thyroid storm with multiorgan dysfunction can be successfully managed.