Hyperthyroidism Case Study

Hyper thyroidalalism Case StudyIntroductionPatient A is a 49 year old distaff of 76 kilograms and height of 161.5 centimetres. The tolerant has attempted to diet but has gained 11.3 kilograms in the previous months. The patient also sleeps for 14-16 hours a day. Her movements were slothful. The patients signs consisted of a slight enlargement of the distinguish area, coarse textured hair and ironic skin. When her blood sample was analysed it constituteed that the hormone T4 (tonne) aims were 3.2 micrograms/millilitre which is lower than the normal range, 4.2-11.2 micrograms/millilitre. In addition to this her thyroid-stimulating hormone (thyroid stimulating hormone) levels were high. diagnosisThe analysis of the weight gain using the diagnosis table shows that this could be as a result of hyperthyroidism or Cushing syndrome or hypothyroidism. The slothful demeanour could be caused by Addisons disease or hypothyroidism. The dry skin of the patient is consistent with the hyp othyroidism retainer.The swelling on the neck could be a goitre which results from a lack of single in the thyroid secretor. Overstimulation causes the thyroid secretor to swell. This swelling could also be a result of hyperthyroidism whereby the thyroid gland secretes to a fault much thyroid hormone and the swelling also results, or it could be a thyroid tumour which also causes the swelling. 1,2The signs and symptoms are consistent with either hypothyroidism or hyperthyroidism and are on the thyroid gland.Cross-section diagram of the neck showing the thyroid gland (106.gif)http//www.patient.co.uk/health/Hypothyroidism-Underactive-Thyroid.htmAnalysis of blood samples and effect of hormones on homeostasisThe hormone T4 speeds up metabolic rates regulates the amount of oxygen used up by cells and regulates body heat. 3 The patients weight gain could be as a result of a decrease in the rate of digestion. Low T4 levels mean that not enough digestive juices are being secreted becau se T4 controls metabolic rates resulting in the slow movement of smooth muscles lining the stomach. T4 promotes the normal development of muscle tone and normal acting of skeletal and cardiac muscles. This possibly explains why the patient is experiencing slothful movement. 1 In addition to this T4 also promotes the hydration of the skin, secretion of the exocrine glands and the growth of hair. The consequences of low T4 could explain why the patients hair is coarse and why the patient has dry skin. 1To distinguish between hyperthyroidism and hypothyroidism a T4 and TSH test have to be done. 4 The TSH test is normally chosen for the evaluation of the thyroid function and for the symptoms of hyperthyroidism or hypothyroidism. It is often done with or after a T4 test.The results of the tests performed show an elevated TSH level and a low T4 level which show that the patient has hypothyroidism.ConditionNormalHyperthyroidismHypothyroidismHypothyroidism SecondaryTSHNormalLowHighLowT4Nor malHighLowLow4WHAT IS HYPOTHYROIDISMHypothyroidism is a condition caused by the underactive functioning of the thyroid gland whereby the thyroid does not stir enough or does not even produce triodothyronine (T3) and thyroxin (T4). 1 The thyroid gland is a butterfly shaped organ which is found inferior to the Larynx and in front of the neck. 1 If the thyroid is underactive hypothyroidism appears. They are dickens types of hypothyroidism and these are primary and secondary hypothyroidism. 4 Primary Hypothyroidism is when the thyroid does not produce T4 and T3 hormones at all. 4 Secondary Hypothyroidism is when the thyroid produces amounts of T3 and T4 which are below the normal levels. 4 The thyroid gland swells up in as a result of it trying to achieve homeostasis. The body has low T4 levels and then the gland works even harder to try and produce more hormones and this causes an increase in the size of the gland.Causes95% of the time the thyroid gland is not secreting sufficient t hyroid hormone and this could cause the hypothyroidism.Hypothyroidism could be an autoimmune disease. The immune system protects the body from foreign substances and infection. However, in this case the immune system mistakes the thyroid gland cells and enzymes, as foreign objects and attacks them resulting in the low business of thyroid hormone. 5Hypothyroidism could also be as a result of Hashimoto disease (chronic thyroiditis). This is a genetic autoimmune disease which could also result the enlargement of the thyroid gland causing goitre. Goitre is a cyst like fibrous growth in the neck region and is caused by an immunologic dysfunction or by an infection and requires lifelong treatment. Stress, poor dieting and strenuous exercise could also cause an imbalance of hormones and leads to hypothyroidism. 6Hypothyroidism can also result from low iodine concentrations in the body. Iodine is required for the proper and normal functioning of the thyroid gland hence insufficient amounts would cause a dysfunction. 5 The enlargement of the gland is an attempt by the thyroid gland to trap more iodine. X-ray radiation, drug abuse and pesticide residues also contribute to having an underactive thyroid gland. 7 Another way of acquiring hypothyroidism could be the after effect of a surgery for example on the removal of thyroid glands. The surgery could be performed on a patient with crabmeat or the Graves Disease but if partially removed it could fail to produce enough thyroid hormone needful to regulate normal and necessary bodily functions. 7-8 Surgery could also be performed on the pituitary gland which sends instructions to the thyroid gland on how much thyroid hormone should be produced. 5 Any damage to the pituitary gland or the hypothalamus could cause hypothyroidism as they both play a role in sending signals to the thyroid gland so that it produces more thyroid hormone.In some cases the condition could arise from the use of drugs such as amiodarone, lithium in terferon alpha, and interkulin-2. These drugs stop the thyroid gland from producing the thyroid hormone at a normal and are likely to trigger hypothyroidism especially in patients with a genetic tendency to auto immune thyroid disease. 5Possible Treatment methodsTo treat hypothyroidism artificial hormones such as Levothyroxine or Liotrix can be administered to the patient so as to replace the hormones T4, TSH or T3 that are lacking in the body. Iodine supplements or iodised salt for those with iodine deficiency can be effective as well. 9-10 The doses of the drugs are not fixed hence the medicine is only formulated when the amount of hormone in the patient has been determined, therefore the patient has to return for constant check-ups after 6 week intervals so that the blood samples and the hormones can be analysed again so that the dosage can be changed. 7-10When treating the elderly that have a history of flavor disease, low doses of the drug have to be administered as this could lead to a greater/increased risk of heart attack. 10For the short term treatment of hypothyroidism, T hormones are used to inhibit the synthesis of TSH in the body. Hormone replacement is predominated by the prolonged effect of T hormones on the level of TSH present.For those who do not prefer drug therapy for hypothyroidism homeopathic remedies are also available. The homeopathic remedies such as Thyax and Thyroidinum 6C can be used to stimulate the thyroid gland to start to produce its own hormone. 11-12PrognosisIf the condition of hypothyroidism is detected early there is a high run into that the condition can be completely controlled using medicine.After treatment with drugs, the levels of thyroid hormones usually return to normal after several months, whereas in other individuals suffering from hypothyroidism, the disorder is a lifelong problem. 13 Their treatment should be taken consistently every day for the abatement of their lives. 14If hypothyroidism goes untreated it c ould lead to other complications. Low thyroxin levels cause the level of lipids and cholesterol to rise, causing the patient to suffer from heart disease. 13 In pregnant women there is an increased risk in having anaemia, still birth and serious haemorrhage after birth or it could lead to a myxoedema coma, which arises due to the low levels of thyroid hormone. 13-14Advantages and disadvantages of chosen treatment methodsWith allopathic remedies there is a chance that if the drug dosage is too low it could cause hypothyroidism and if the drug dosage is too high it could lead to hyperthyroidism.The homeopathic remedies are the best treatment methods as compared to the supplementation medications as it aids the gland to function properly, whereas in the supplementation medications the gland could become too dependent on the drugs and throw the other glands in the body off balance. 12 If the doses of the artificial hormones are not check or changed, with time this could lead to hyperth yroidism.Prevention methodsThere are no medication rubber methods for hypothyroidism, but a healthy diet can protect and preserve ones health. The patient can take iodine supplements in their food and this reduces the risk of them detection it. Exercising, getting enough sleep, relaxation are ways in which hypothyroidism future problems can be avoided. Exercise is another activity that boosts the levels of thyroid hormone therefore reducing the risk of hypothyroidism. 15ConclusionThere is no cure to the condition therefore the patient will have to keep taking medicine for the rest of their lives. The patient will have to go for constant check-ups in order to change the dose according to the thyroid hormone levels that they have, and the misuse of the drugs could make their condition worse. 16