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12 years ago
Carl is suffering from hypothyroidism. What is hypothyroidism? How could his physician determine whether the malfunction is in the hypothalamus and pituitary or at the level of the gland itself?
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12 years ago
Hypothyroidism is an endocrine disorder caused by a reduction or absent of thyroid hormones. Dysfunction in the thyroid gland itself causes primary hypothyroidism. Central hypothyroidism is due to malfunction of the pituitary gland, hypothalamus or both. Exclusive pituitary gland failure results to a pituitary or secondary hypothyroidism. If low levels of thyroid-stimulating hormones (TSH) result from a defective hypothalamus the condition is referred as hypothalamic or tertiary hypothalamus. Hypothyroidism present at birth (congenital) is called cretinism.
The most common cause of a hypothyroid state is the presence of an autoimmune disease. The major hormone released by the thyroid gland is called thyroxine (T4). Normally, the thyroid gland releases 5-12 mcg/dl or 65-154 nmol/L of thyroxine (T4) in a daily basis. The half-life of T4 is roughly 7-10 days. Triiodothyronine (T3), the second thyroid hormone, is released in smaller amounts.
In the early stage of the disorder, the hypothalamus triggers a massive release of thyrotropic-releasing hormone (TRH) as a compensatory mechanism for thyroid hormone deficiency. TRH is the one responsible for stimulation of the anterior pituitary gland to release thyroid-stimulating hormone (TSH), also called thyrotropin. The TSH then binds with the follicular cells in the thyroid gland to activate the release of the stored thyroid hormones (T3 and T4) to tissues. Hypofunctioning of the thyroid glands leaves the TSH unused and the APG continually releasing it due to hypothalamic stimulation. As a result hypertrophy of the thyroid gland (goiter) occurs.
Thyroid hormones are the body’ major metabolic. They are primarily responsible for cellular metabolism affecting all cells in the body.
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