Thyroid Gland

Thyroid gland is an endocrine

gland, situated in lower part of
front of the neck.
The normal thyroid gland weighs
20-25 g. It secrets T3 & T4 and
bound to serum protein.
The small amount of hormone that
remain free in the serum is
biologically active.
Functions:
It regulate basal metabolic rate.
Stimulate somatic & psychic growth.
Plays an important role in calcium
metabolism.
Control of thyroid hormone
secretion:

When serum thyroid hormone is low, anterior

pituitary release TSH for synthesis and
liberation of hormone. (Negative feedback
mechanism)
Goitre:

Enlargement of thyroid gland is

called goiter.
Causes of thyroid swelling:
1. Simple goitre (Euthyroid)
Diffuse hyperplastic- Physiological,
Puberty, Pregnancy
Multinodular goitre
2. Toxic-
Diffuse- Graves’ disease
Multinodular
Toxic adenoma
3. Neoplastic- Benign
Malignant
4. Inflammatory- Autoimmune
Granulomatous
Fibrosing
Infective
Hypothyroidism:
Causes:
1. Autoimmune thyroiditis (Chronic
lymphocytic thyroiditis)
2. Iatrogenic: After thyroid surgery, after
radio-iodine therapy, drug induced
3. Dyshormonogenesis
4. Goitrogens
5. Secondary to pituitary or
hypothalamic diseases
6. Thyroid agenesis

7. Endemic cretinism
Adult Hypothyroidism

Features:
General:
Tiredness, somnolence, weight
gain, cold intolerance, hoarseness
of voice.
Cardiorespiratory:
Bradycardia, pericardial effusion,
pleural effusion
Neuromuscular:
Delayed relaxation of tendon
reflexes, carpal tunnel syndrome,
depression
Haematological:

Anaemia
Dermatological:

Dry skin, myxoedema

Reproductive:

Menorrhagia, Infertility
Gastro-intestinal:

Constipation, ascites
Investigation:

FT3, FT4 decreased

TSH Increased
Treatment:
Thyroid hormone replacement
Hyperthyroidism
Causes:
Diffuse toxic goiter (Graves’
disease)
Toxic nodular goiter
Toxic nodule
Clinical Features:
GIT:
Weight loss despite increased
appetite, hyperdefaecation,
diarrhoea
Cardiorespiratory:

Palpitation, atrial fibrillation,

dyspnea on exertion
Neuro-muscular:

Nervousness, irritability, emotional

lability, psychosis, tremor, muscular
weakness, proximal myopathy
Dermatological:
Heat intolerance, increased sweating,
alopecia, pre-tibial myxoedema
Reproductive:

Amenorrhoea/oligomenorrhoea,
infertility
Ocular:
Lid lag, lid retraction, chemosis,
exophthalmos, ophthalmoplegia
Investigation:

FT4, FT3 Increased

TSH decreased
Treatment:
Anti-thyroid drugs:

Carbimazole
Propranolol
Surgery:

Sub total thyroidectomy

Hemithyroidectomy
Total thyroidectomy
Radio iodine ablation