Micronutrients
Chuong Pham-Huy, Bruno Pham Huy in Food and Lifestyle in Health and Disease, 2022
The other physiological role of thyroid hormones is to control several metabolic processes in the body. These include the metabolism of carbohydrate, fat, protein, vitamin, and mineral. For example, thyroid hormone increases energy production, increases lipolysis, and regulates neo-glucogenesis, and glycolysis (3). Moreover, thyroid hormones are used to stimulate enzyme synthesis, oxygen consumption, basal metabolic rate, and a wide variety of other physiological activities such as heart rate and respiratory rate (4). However, under different circumstances, excess iodine intake can cause hyperthyroidism (thyrotoxicosis) and toxic nodular goiter (4, 8). Hyperthyroidism is largely confined to people over 40 years of age. Symptoms of hyperthyroidism include palpitations, trembling, nervousness, weight loss, lack of sleep, tremor, high blood pressure, excessive sweating, and heat intolerance (4). Indeed, too little or too much iodine in the body can cause goiter, an enlargement of the thyroid gland.
Endocrinology
Kristen Davies, Shadaba Ahmed in Core Conditions for Medical and Surgical Finals, 2020
Other causes of hyperthyroidism include: Toxic multinodular goitre: Nodules that secrete thyroid hormone, treated with radioiodine/surgery.Toxic adenoma: Solitary nodule producing thyroid hormone. Appears ‘hot’ on isotope scan. Treated with radioiodine.Ectopic thyroid tissue (e.g. from choriocarcinoma, ovarian teratoma).Exogenous thyroid (diet, excess levothyroxine).Subacute (de Quervain's) thyroiditis: Postviral hyperthyroidism with a painful goitre. Investigations show a raised ESR and low isotope uptake on scan. Treated with NSAIDs.Iatrogenic: Amiodarone, lithium.Postpartum thyroiditis: Occurs in 7% of women a year after giving birth.
Thyroid disease
Judy Bothamley, Maureen Boyle in Medical Conditions Affecting Pregnancy and Childbirth, 2020
It is suggested that PPT occurs in 5–10% of pregnancies (Stagnaro-Green, 2000), although other authorities have found a much lower incidence (Girling, 2006). It is an autoimmune disorder and there is an increased risk for those with thyroid antibodies in the first trimester, insulin-dependent diabetes (up to 25% may develop PPT [Casey and Leveno, 2006]) and a past history of this disorder. Onset is usually within the first few months postnatal. Most women progress through hyperthyroidism and hypothyroidism, then symptoms spontaneous resolve, usually within 12 months (Casey and Leveno, 2006). Presenting symptoms may include depression and memory impairment (Casey and Leveno, 2006). Treatment for the hyperthyroidism and hypothyroidism may be necessary (Gallas, et al., 2002; Stuckey, et al., 2001). It is suggested that up to 30% of these women will go on to develop permanent hypothyroidism (Casey and Leveno, 2006), therefore a yearly follow-up should be carried out (Stagnaro-Green, 2000) and increased monitoring performed after future pregnancies as reoccurrence is likely (Keely and Barbour, 2008).
Thyrotoxicosis factitia: a rare cause of junctional rhythm and cardiac arrest
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Sohaib Roomi, Waqas Ullah, Iqra Iqbal, Asrar Ahmad, Sameer Saleem, Zeeshan Sattar
A hyperthyroid state can be divided into two main categories, thyrotoxicosis, i.e. hyperfunctioning of the thyroid gland or exogenous intake of thyroid hormone. The thyrotoxicosis state is well known for its numerous adverse effects on the body however little is known regarding the exogenous thyroid hormone toxicities. It can have a variety of adverse effects depending on the system involved and the amount of intoxication. Although the symptoms of hyperthyroidism from factitious ingestion can be similar to the symptoms from thyrotoxicosis including weight loss, heat intolerance, tremor, palpitations, anxiety, increased frequency of bowel movements, or shortness of breath, there can be some physical signs specific to a specific cause. For instance, there will be no exophthalmos and thyromegaly in factitious hyperthyroidism while lid lag and stare can be seen in both exogenous and endogenous hyperthyroidism [3]. Our patient’s eyes were red and swollen but since they were reported to be normal before the cardiac arrest that rules out Graves’ disease and suggests that swelling of her eyes was as a result of brain edema after the cardiac arrest. Thyrotoxicosis in old age is notorious for cardiac complications while the adverse events related to factitious hyperthyroidism are still unknown.
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.
Related Knowledge Centers
- Heat Intolerance
- Tachycardia
- Thyroid Hormones
- Tremor
- Weight Loss
- Diarrhea
- Thyroid
- Pregnancy
- Goitre
- Thyroid Storm