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INTRODUCTION
Thyroid gland is the largest gland in a normal adult. The gland weighs 15- 25g.
It is a highly vascular organ. The gland is bilobed and connected by a bridge of
tissue called isthmus.
The function of the gland is controlled by thyroid stimulating hormone, TSH
from anterior pituitary which is regulated by thyrotropin releasing hormone,
TRH from hypothalamus .Thyroid hormones, T3 and T4 in circulation, provide
negative feedback on secretion of TSH and TRH on anterior pituitary and
hypothalamus respectively.
REGULATION OF TSH SECRETION:
They are important for normal body growth. Thyroid gland produces two main
hormones -T3 and T4.
FORMATION OF THYROID HORMONE
1. Iodine from diet is converted to Iodide which is reabsorbed into thyroid cells
by Iodide pump.
2. Iodide pump is mediated by Na+- K+ dependent ATPase system.
3. Iodide is transported into colloid and gets oxidized by thyroid peroxidase into
iodine, I2.
4. I2 then gets bound to 3 position of tyrosine forming mono- iodo- tyrosine,
MIT and di-iodo-tyrosine, DIT.
5. Thyroid peroxidase and coupling enzymes form T3 and T4.
6. Iodinated T3 and T4 are deiodinated by Iodotyrosine dehalogenase and
secreted into circulation.
2. Protein Metabolism:
In physiological dose: T4 is anabolic and increases protein synthesis.
IN PHARMACOLOGICAL DOSES, T4 has catabolic effect on body
3. Carbohydrate metabolism:
Thyroid hormone in physiologic dose,
Increase peripheral utilization of glucose, can cause
hypoglycemia.
Increase glucose absorption from intestine
Increase glycogenesis
Increase gluconeogenesis
Decrease breakdown of insulin.
Thyroid hormones precipitate Diabetes Mellitus in hyperthyroid
patients.
4. Lipid metabolism
Increase breakdown of cholesterol in the liver
Stimulate degradation of lipids.
5. Cardiovascular system:
Increase in heart rate.
Increase in force of myocardial contraction.
Increase in systolic BP.
Fall in diastolic BP.
Increase in O2 consumption, leading to cardiac arrhythmias.
7. Nervous system
8. GIT:
CAUSES
1. Iodine deficiency in diet 1.Graves disesease
2. Hashimotos thyroiditis 2.Toxic multinodular goiter
3. Pituitary hypothyroidism 3. TSH secreting tumor
4. Hypothalamic hypothyroidism 4. Excess intake of T3, T4.
CLINICAL FEATURES:
1. CALORIGENIC ACTION:
BMR Decreases Increases.
Goitre Exophthalmos
Puffiness of face
Cold intolerance Heat intolerance
Weight gain Weight loss
Dry, thickened, rough skin. Skin: warm, moist, soft
2. CNS:
3. GIT :
4. CVS
6. Hypoglycemia Hyperglycemia
ANTITHYROID DRUGS:
HYPOTHYROIDISM HYPERTHYROIDISM
THYROID GLAND
a) Thyroid hormones.
b) Stress
c) Glucocorticoids
d) Decreased T3.
7. In hyperthyroidism:
a) Tachycardia
b) Constipation
c) Depression
d) Weight gain.