Thyroid Gland
A gland present in the base of the neck that controls basic metabolic activities. The hormones produced by the thyroid gland T3[triodothyronine], T4[thyronine] have multiple receptors throughout the body. The receptors respond accordingly controlling the activities like body weight, temperature, muscle strength, breathing, heart rate, chemical balance like cholesterol level, central nervous system, etc.
Thyroid Related Conditions
Thyroid gland disorders have been a major problem in developing countries. The endemic areas of goiter in higher altitudes are found. Thyroid hormone deficiency and excess both are equally fatal but here we are concerned with excessive thyroid hormone.
Hypothyroidism[ low serum T3& T4] related disorders include cretinism in neonates and infants, myxedema in adults and its causes, iodine deficiency &autoimmune Hashimoto's thyroiditis
Hyperthyroidism[high serum T3&T4] Related disorders include Graves disease, Thyrotoxicosis, Thyroid storm, multinodular goiter
the anxious look of the patient may be indicative of hyperthyroidism.
When I was in medical school I always thought the terms Hyperthyroidism, thyrotoxicosis, and thyroid storm are the same but was confused why they are used in a different context so now I would like to clear all my previous confusion.
1. Hyperthyroidism
Excessive activation of the thyroid gland when leads to a high serum level of thyroid hormones T3, T4 and the production of symptoms related to excessive T3 and T4.
1.Basal metabolic rate increases due to increased synthesis of active energy expending sodium-potassium pumps
2.Sympathetic nervous system activity increased due to increased expression of B-1 adrenergic receptors
All the following symptoms result from the above two mechanisms
weight loss despite increased appetite
Anxiety
heat intolerance
sweating
tachycardia with increased cardiac output
arrhythmia especially in elders
staring gaze with lid lag sign
Diarrhea with malabsorption
bone resorption
decreased muscle mass with weakness
Hypocholesterolemia
Hyperglycemia
Thyrotoxicosis
Thyrotoxicosis is a symptoms-based triad of Hyperthyroidism, ophthalmopathy, and skin rashes. In thyrotoxicosis thyroid hormone in excess may be due to any cause not just produced from the thyroid gland.
Thyroid storm
Thyroid Storm is actually a potentially fatal complication of the conditions described above. During stress or emergency conditions like pregnancy or surgery, infection, our adrenal glands under stress released a large number of catecholamines; epinephrine, or norepinephrine. In excessive thyroid presence, the beta-adrenergic receptors for catecholamines to act are in enormous amounts. So, a storm of B adrenergic overactivity overpowers the previous fewer harm conditions. Following are the fatal mechanisms resulting from B adrenergic overactivity.
Arrhythmia
Hyperthermia
vomiting with hypovolemic shock
Diagnosis & Treatment
Laboratory diagnosis is based on serum T3, T4, and TSH levels.TSH level tends to low while others T3, T4 remain high.
The treatment plan for Thyroid storm contains Propylthiouracil that inhibits thyroid hormone synthesis as well as the active conversion of T4 to T3 to act on receptors.
B blockers are given to reverse the symptoms.
Steroids are always treatment options for complicated fatal conditions.
How to Prevent Thyroid storm?
People living in endemic areas with thyroid problems should be followed up for regular checkups. A family history of hyperthyroidism or hypothyroidism or goiter may predispose the condition. So all family members should be addressed for proper regular checkups. The diet should contain iodinated salt. In a nutshell, hyperthyroidism should be treated as soon as possible because untreatable and persistent hyperthyroidism leads to Thyroid storms under some stress conditions.
nice content
Thank you@Sidra
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