Regulation of the Pituitary Gland by Dopamine
Nira Ben-Jonathan in Dopamine, 2020
Diagnosis of potential thyroid dysfunctions starts with a history and physical examination. If dysfunction of the gland is suspected, laboratory tests can help support or rule out thyroid disease. As illustrated in Figure 5.15, a sensitive serum TSH assay can be initially used to indicate which additional diagnostic steps should be undertaken. If an autoimmune disorder of the thyroid such as Grave’s disease is suspected, blood tests, looking for antithyroid autoantibodies, can be obtained. Ultrasound, biopsy and radioiodine scanning and uptake may be used to help with the diagnosis, particularly if a nodule is suspected. Treatment of thyroid disease varies, based on the disorder. Levothyroxine is the mainstay of treatment for hypothyroidism, while hyperthyroidism caused by Graves’ disease can be managed with iodine therapy, antithyroid medication, or surgical removal of the thyroid gland. Thyroid surgery may also be performed to remove a thyroid nodule or to reduce the size of a goiter if it obstructs nearby structures or for cosmetic reasons.
Surgery for well-differentiated thyroid cancer
Demetrius Pertsemlidis, William B. Inabnet III, Michel Gagner in Endocrine Surgery, 2017
Once a dominant thyroid nodule is detected on self-exam or incidentally on imaging, the next step is thorough physical exam and TSH measurement. All patients with nodular thyroid disease should also be assessed for key risk factors and signs of thyroid cancer, such as a rapidly growing mass, hoarseness, dysphagia to solids, positional dyspnea, local pain, radiation history, or pertinent family history. In hypothyroid patients, T4 is adequately replaced and nodule size is monitored briefly for stability. Hyperthyroidism is uncommon in thyroid nodule patients, and their evaluation follows a different diagnostic algorithm that includes nuclear imaging, as well as ultrasound (US). Of nodules detected on 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) scan, about 30% are found to be DTC, and further workup with US-directed FNAB is recommended [19].
Surgical approach to thyroid disorders
David S. Cooper, Jennifer A. Sipos in Medical Management of Thyroid Disease, 2018
Surgery for the thyroid gland began pre-Renaissance and was advanced with modern techniques by renowned surgeons, including Kocher, Billroth, and Halstead (1). Indeed, the 1909 Nobel Prize in Medicine was awarded to Theodor Kocher for his work on thyroid physiology and surgery. The role of surgery as a definitive treatment for certain thyroid diseases is well documented. Thyroid surgery is technically challenging, but a systematic approach to the anatomy enables accurate resection with low morbidity. The surgical indications and approaches to different diseases of the thyroid will be discussed in this chapter. The pre- and postoperative considerations, risks, and complications will be reviewed. Lastly, new advancements in the surgical approach to thyroid diseases, including transoral surgery, will be highlighted.
Thyroid hormone levels and structural parameters of thyroid homeostasis are correlated with motor subtype and disease severity in euthyroid patients with Parkinson’s disease
Published in International Journal of Neuroscience, 2021
Yinyin Tan, Lei Gao, Qingqing Yin, Zhanfang Sun, Xiao Man, Yifeng Du, Yan Chen
Thyroid disease refers to the endocrine dysfunction, which is most frequently associated with PD [6]. In PD patients, the hypothyroid symptoms may be ambiguous, because the parkinsonism and hypothyroidism share some common clinical features, such as bradykinesia and hypomimia [6]. Considering this coexistence, the uncommon phenomenon should be expected: the estimated prevalences of both the disorders tend to increase with advancing ages. Prevalence of hypothyroidism among adults varies between 2.3% and 18%, while the prevalence of PD ranges from 0.1% to 1.4% [7,8]. In contrast, hyperthyroidism would worsen the parkinsonian tremor and cloud the levodopa responses in newly diagnosed PD patients [9]. Occurrence of hyperthyroidism in elderly PD patients may be overlooked due to subtle symptoms and signs [10]. Overall thyroid function has also been determined in patients with PD, though not any conclusive answer has been driven in regard to what role, if any, the thyroid function plays in the pathogenesis of PD. Several studies have shown that there is no significant relationship between the thyroid function and PD pathogenesis [11–13], while others have demonstrated association between them[14,15]. Compared with normal subjects, subclinical hyperthyroidism is more prevalent in the PD patients, and the free thyroxine (fT4) levels are elevated in the de novo, medication-free PD patients [14,16].
Comparing the effects of Portulaca oleracea seed hydro-alcoholic extract, valsartan, and vitamin E on hemodynamic changes, oxidative stress parameters and cardiac hypertrophy in thyrotoxic rats
Published in Drug and Chemical Toxicology, 2022
Roghayeh Pakdel, Mehran Vatanchian, Saeed Niazmand, Farimah Beheshti, Maryam Rahimi, Azita Aghaee, Mousa-Al-Reza Hadjzadeh
There is a close relationship between thyroid hormones and cardiac function. Most of the signs and symptoms of thyroid diseases are because of effects of thyroid hormone action on the cardiovascular system (Razvi et al.2018). Several studies have shown that increased thyroid hormone levels are associated with an increase in cardiac output, cardiac hypertrophy, and a decrease in peripheral vascular resistance. Cardiovascular manifestations of hyperthyroidism include tachycardia, atrial fibrillation, hypertension, widened pulse pressure, cardiac hypertrophy, and even heart failure (Vargas-Uricoechea et al.2014). Thyroid hormones, thyroxine (T4) and triiodothyronine (T3), impinge upon the cardiovascular system directly at the cellular level and indirectly through the hormonal and/or nervous system (Danzi and Klein 2014).
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].
Related Knowledge Centers
- Hyperthyroidism
- Thyroid Hormones
- Triiodothyronine
- Endocrine System
- Neoplasm
- Thyroid
- Levothyroxine
- Hypothyroidism
- Goitre
- Thyroid-Stimulating Hormone