Alteration of hormonal

regulation
Questions 4-6
Group 4:
Kedama Aiwoki, Elizabeth Undaba, John Konigala,
Vitus Anton, Hadassah Imbans, Darren Kiele
Topics/Outline
4. Characterize the manifestations of hypothyroidism and hyperthyroidism.
5. Describe the disorders of hyperthyroidism; note the progressive states of severity.
6. Describe the disorders of hypothyroidism.
Learning Outcomes
By the end of this presentation student students should be able to:
1. Name and describe the different clinical manifestations of Hypothyroidism and
Hyperthyroidism.
2. Describe the different disorders of Hyperthyroidism.
3. Describe the different disorders of Hypothyroidism.
 4. Characterize the Clinical
Manifestations of Hypothyroidism
and Hyperthyroidism
Clinical Manifestations of
Hypothyroidism
Clinical manifestations of
Hyperthyroidism
Symptoms Signs (Clinical features
• Increased appetite • Bulging eyes
• Weight loss • Swelling at base of neck (Goiter)
• Sweating • Red, swollen skin
• Nervousness • Heart problems
• Anxiety • Osteoporosis
• Irritability • Feverish
• Insomnia
• Heart palpitations
• Shakiness
• Heat intolerance
• Eye pain
• Skin thinning
• Fine, brittle hair
 5. Describe the disorders of
hyperthyroidism; note the
progressive states of severity.
Thyrotoxicosis occurs when there is increased levels/release of thyroid hormones(THs) from
any source.
Thyrotoxicosis means an excess of thyroid hormone in the body. Having this condition also
means that you have a low level of thyroid stimulating hormone(TSH) in your bloodstream,
because the pituitary gland senses that you have “enough” thyroid hormone.
Hyperthyroidism is a form of thyrotoxicosis in which excess THs are secreted by the thyroid
gland.
Primary hyperthyroidism diseases include Graves disease, toxic multinodular goiter, and
solitary toxic adenoma.
Secondary hyperthyroidism is less common and is caused by TSH-secreting pituitary
adenoma.
Non-associated thyrotoxicosis is seen with hyperthyroidism in subacute thyroiditis, increased
TSH secretion, ectopic thyroid tissue, and ingestion of excessive TH.
All forms of thyrotoxicosis share some common characteristics because of increased
circulating levels of THs. The major types of therapy used to control the elevated levels of TH
include;
 drug therapy
 radioactive iodine therapy
 surgery.
Graves disease;
a form of type II hypersensitivity
the most common form of hyperthyroidism and is associated with
autoantibodies against the TSH receptor.
The antibody binds to the plasma membrane and initiates thyroid
hyperplasia of the gland (goiter), vascularity, and hypersecretion of
hormone.
Ophthalmopathy is characterized by;
edema of the orbital contents,
exophthalmos,
extraocular muscle weakness that sometimes leads to diplopia and
pain, lacrimation, photophobia, and blurred vision.
Treatment consists of a combination of radioactive iodine, surgery, or
antithyroid drugs.
Thyrotoxic crisis (thyroid storm) is a rare but a deadlier state of the thyrotoxicosis; death can
occur within 48 hours without appropriate treatment.
This condition occurs most often in individuals with undiagnosed or partially treated severe
hyperthyroidism and who are subjected to excessive stress from other causes.
The systemic symptoms of thyrotoxic crisis include hyperthermia, tachycardia, high-output
heart failure, agitation or delirium, nausea and vomiting, or diarrhea contributing to fluid and
electrolyte depletion.
The symptoms may be caused by increased b-adrenergic receptors and catecholamines.
The treatment is to reduce circulating TH levels by blocking TH synthesis.
6. Describe the disorders of
hypothyroidism
Hypothyroidism
Condition in which the thyroid gland isn’t producing enough thyroid hormone.

Three types of Hypothyroidism:

1. Primary Hypothyroidism
- low levels of blood thyroid hormone due to destruction of the thyroid gland
2. Secondary Hypothyroidism
- decreased activity of the thyroid caused by failure of the pituitary gland
3. Tertiary Hypothyroidism
- inadequate secretion of thyrotropin-releasing hormone (TRH) from the hypothalamus leads to
insufficient release of TSH, which in turn causes inadequate thyroid stimulation
Disorders of hypothyroidism
Untreated hypothyroidism can lead to a number of health problems:
Goiter. Thyroid gland becomes larger due to constant stimulation to release
more hormones. May interfere with swallowing or breathing.
Heart problems. High levels of low-density lipoprotein (LDL) cholesterol —
the "bad" cholesterol — can occur due to an underactive thyroid.
Mental health issues. Depression may occur early in hypothyroidism and may
become more severe over time. Hypothyroidism can also cause slowed mental
functioning.
Peripheral neuropathy. Long-term hypothyroidism can cause damage to
peripheral nerves. Peripheral neuropathy may cause pain, numbness and tingling
in affected areas.
Myxedema. Characterized by intense cold intolerance and drowsiness followed
by profound lethargy and unconsciousness.
A myxedema coma may be triggered by sedatives, infection or other stress on
the body.
Infertility. Low levels of thyroid hormone can interfere with ovulation, which
impairs fertility. In addition, some of the causes of hypothyroidism — such as
autoimmune disorder — can also impair fertility.
Birth defects. Pregnant women with untreated thyroid disease may give birth to
children who are more prone to serious intellectual and developmental
problems.
Infants with hypothyroidism are at risk of serious problems with both physical
and mental development. But if this condition is diagnosed within the first few
months of life, the chances of normal development are excellent.
Summary
Hyperthyroidism is a form of thyrotoxicosis. Results from an increase release of
thyroid hormones.
Clinical manifestations include: increased appetite, weight loss, sweating, bulging
eyes, goiter
Two types of hyperthyroidism diseases: primary (graves disease) and secondary
Summary
Hypothyroidism is a condition in which the body (thyroid gland) isn’t producing
enough thyroid hormone.
Some clinical manifestations include: hypothermia, brachycardia, fatigue,
weakness, weight gain.
There are three types of hypothyroidism disorders: primary, secondary and tertiary.
Some disorders of hypothyroidism include: goiter, heart problems, mental health
issues.
References
Huether SE, McCance KL. Study Guide for Understanding Pathophysiology
[Internet]. Study Guide for Understanding Pathophysiology. 2012. Available from:
http://evolve.elsevier.com