1. What type of thyroid disease does Elena have?
When TSH (thyroid-stimulating hormone) is high outside of its normal rage, which Elena’s is, it means she has hypothyroidism (ATA, 2012).
References
American Thyroid Association. (2012). Hypothyroidism. Retrieved from
http://www.thyroid.org/what-is-hypothyroidism/.
2. Why are Elena’s TSH levels elevated, but free T4 levels in the normal range?
Elena’s TSH levels are elevated because there is not enough T4 in her blood. Therefore, her body tries to compensate by producing a more than normal amount. This is how doctors can quickly detect hypothyroidism (ATA, 2012).
On the other hand, however, her free T4 levels are in normal range. This could be because “T4 is not the only hormone involved in thyroid function, a normal result on this test may not mean that you do not have a thyroid problem” (Holm, 2014).
In primary hypothyroidism, the thyroid gland is less able to produce the thyroid hormones, T4 and T3. The pituitary gland responds to the deficiency by secreting more TSH. Therefore, in mild cases of primary hypothyroidism, TSH levels will be high, but T4 levels are normal (Friedman, 2006).
References
American Thyroid Association. (2012). Hypothyroidism. Retrieved from
http://www.thyroid.org/what-is-hypothyroidism/.
Friedman, T. (2006). Hypothyroidism Diagnosis and Treatment. Retrieved from
http://thyroid.about.com/cs/hashimotos/a/tedfriedman.htm.
Holm, G. (2012). Primary Hypothyroidism. Heathline. Retrieved from
http://www.healthline.com/health/hypothyroidism-primary#Overview.
3. Given Elena’s lab results, what would you expect her levels of TRH to be?
TSH is produced when the hypothalamus releases thyrotropin-releasing hormone (TRH). Therefore, if Elena is producing high levels of TSH, and TRH produces TSH, chances are Elena’s TRH levels are also high.
References
American Thyroid Association. (2012). Hypothyroidism. Retrieved from
http://www.thyroid.org/what-is-hypothyroidism/.
4. Why do you think TSH is measured instead of TRH?
TSH is measured instead of TRH because the tests are completely different. They both test for the same end product, but the roads in which each take are not alike. The TSH is a simple blood test. A TRH test involves much more.
For a TRH test, a baseline TSH test is done. Then, the patient is injected with TRH, which stimulates the pituitary release of TSH. After, TSH levels are retested about 20-30 minutes later. It seems to be much more invasive as well as time consuming. The TSH test is a picture in time of circulating levels of thyroid hormone. Doctors consider the TSH test highly accurate and only requires only one blood draw instead of two (Shomon, 2007).
References
Shomon, M. (2007). The TRH Stimulation Test: Is There a Place for This Challenge Test? Retrieved from
http://thyroid.about.com/od/gettestedanddiagnosed/a/trhtest.htm.
5. Will the medication Elena takes for her disorder mimic the effects of TSH, or T4? Why is this?
Hypothyroidism is treated by certain medication. Synthetic thyroxine pills contain hormone exactly like the T4. Therefore the medication mimics the effects of T4. The medication replaces the amount of hormone that your own thyroid cannot produce. It helps bring T4 and TSH levels back to normal. Even if the thyroid gland cannot function properly, T4 replacement can restore the body’s thyroid hormone levels and function (ATA, 2012).
References
American Thyroid Association. (2012). Hypothyroidism. Retrieved from
http://www.thyroid.org/what-is-hypothyroidism/.