The endocrine system
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella in Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Hyperthyroidism results from the increased synthesis and release of the thyroid hormones T3 and T4. Hyperthyroidism may be a primary condition that results from an overactive thyroid gland or it may occur secondary to excessive stimulation of the thyroid by TSH from the pituitary. Secondary hyperthyroidism is a rare condition that may be caused by a pituitary adenoma. Hyperthyroidism is also referred to as thyrotoxicosis due to the range of serious physiologic alterations that occur as a result of increased circulating thyroid hormone levels. One of the most common causes of hyperthyroidism is Graves’ disease (see below). In rare cases carcinomas arising outside of the thyroid may produce thyroid hormone or TSH.
BMI and Male Fertility
Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh in Male Infertility in Reproductive Medicine, 2019
Medication: Those who experience secondary hypogonadism from weight loss require different treatment methods. The type of medication used depends upon the etiology of the weight loss. For example, in individuals who have an overactive thyroid, as seen in hyperthyroidism, antithyroid medication, thyroidectomy, and radioactive iodine administration are all options for treatment [52]. Furthermore, antioxidants like melatonin and vitamin E were given to men with infertility and hyperthyroidism; this showed promising results for the improvement of sperm quality [52,73,74]. Radioiodine therapy is the first-line treatment for such conditions in male adults because surgery is a last resort and antithyroid drugs only work in the short term [19,75].
Thyroid disease in pregnancy
Moshe Hod, Lois G. Jovanovic, Gian Carlo Di Renzo, Alberto de Leiva, Oded Langer in Textbook of Diabetes and Pregnancy, 2018
The etiology of PPT is a destructive thyroiditis. It may present up to 9 months after delivery with a transient hyperthyroidism and/or hypothyroidism.72 Using the correlated thyroid function tests, it is possible to diagnose the specific thyroid dysfunction, i.e., hyperthyroidism or hypothyroidism. The clinical course include hyperthyroidism alone, hypothyroid phase alone, and hyperthyroidism followed by hypothyroidism in 19%, 49%, and 32% of patients, respectively. Remarkably, prominent symptoms in the hyperthyroid phase, and even in antibody-positive patients without any thyroid dysfunction, are irritability and lack of energy. Conversely, the hypothyroid status may present with intense symptomatology.
Analysis and evaluation of the efficacy of ultrasound-guided microwave ablation for papillary thyroid microcarcinoma
Published in International Journal of Hyperthermia, 2021
Xinya Wang, Xiaoyan Niu, Shuang Mu, Mingzhu Zhang, Wenbin Jiang, Lixue Zhai, Danni Jiang, Wanqing Tang, Cheng Zhao
No obvious complications were noted during the surgery procedure. However, during the post-procedural follow-up, the incidence of complications in the surgery group was significantly higher than that in the ablation group. All patients in the surgery group were required to take thyroxine tablets regularly after the surgery. For the thyroid function test, thyroid dysfunction was detected in 87% (72/83) of patients (clinical hyperthyroidism, 49% [41/83]; subclinical hyperthyroidism, 27% [22/83]; clinical hypothyroidism, 4% [3/83]; subclinical hypothyroidism, 7% [6/83]) at 1-month review after surgery. Of 72 patients, 46% had not recovered the thyroid function after more than 12 months, and 6% of these patients still had thyroid dysfunction after 24 months of follow-up, which was considered a permanent thyroid function injury. Other complications, including temporary dysphagia (confirmed by laryngoscopy as laryngeal edema), temporary lymphatic fistula, permanent hoarseness, and parathyroid dysfunction, were noted in the surgery group.
Evaluation of malpractice litigation in thyroid disease in the National Health Service
Published in Postgraduate Medicine, 2019
Tharindri D. Wijekoon, Daniel E. Gonzalez-Pena, Sabapathy P. Balasubramanian
In the United Kingdom, thyroid disease is managed by primary and a wide range of secondary care specialities, inclusive of endocrinologists, general, endocrine, and ENT surgeons. The most common cause of thyroid disease worldwide is iodine deficiency, while in iodine-replete areas, autoimmune disease is prevalent, ranging from hypothyroidism due to Hashimoto’s thyroiditis to hyperthyroidism due to Graves’ disease [1,2]. The mainstay of treatment for hypothyroidism involves levothyroxine replacement, while treatment options for hyperthyroidism include anti-thyroid drugs, radioiodine, and surgery [3]. Thyroid cancers constitute over 90% of endocrine cancers but comprise of <1% of all malignancies in UK and are treated primarily surgically [2,3]. In anaplastic thyroid carcinoma, a tumor characterized by poor prognosis, risk of recurrence and local invasiveness, surgery has an important palliative role to improve local control, treat compressive symptoms and improve quality of life; alone or as part of a multimodal approach dependent on multiple factors including tumor size [4].
Recurrent thyrotoxicosis following near-total thyroidectomy
Published in Baylor University Medical Center Proceedings, 2020
Paul Gaschen, Joehassin Cordero, Alan N. Peiris
Graves’ disease, an immune-mediated disorder associated with elevated thyroid-stimulating immunoglobulins (TSIs), is a common cause of hyperthyroidism. Hyperthyroidism is usually treated with medication, radioactive iodine, or surgery. Recent evidence indicates that radioactive iodine treatment may increase the risk of solid tumors1 and exacerbate Graves’ ophthalmopathy. Thyroidectomy may also be considered an accepted therapy during the second trimester of pregnancy.2 Additionally, there has been a preference for total thyroidectomy in the treatment of hyperthyroidism. Total thyroidectomy produces better outcomes than subtotal thyroidectomy because of the reduced rate of recurrent thyrotoxicosis.3 As such, total thyroidectomy has been assumed to be curative in hyperthyroidism. In this article, we present the rare case of recurrent thyrotoxicosis following near-total thyroidectomy.
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