THYROID

DEFINATION
The thyroid gland or simply, the thyroid in vertebrate anatomy, is one of the largest endocrine glands. The thyroid gland is found in the neck, below the thyroid cartilage. The thyroid gland controls how quickly the body uses energy, makes proteins, and controls how sensitive the body is to other hormones. It participates in these processes by producing thyroid hormones, the principal one being tri iodothyronine (T3) and thyroxine which can sometimes be referred to as tetra iodothyronine (T4). These hormones regulate the growth and rate of function of many other systems in the body. T3 and T4 are synthesized from iodine and tyrosine. The thyroid also produces calcitonin, which plays a role in calcium homeostasis. Hormonal output from the thyroid is regulated by thyroidstimulating hormone (TSH) produced by the anterior pituitary, which itself is regulated by thyrotropin-releasing hormone (TRH) produced by the hypothalamus

HISTORY
There are several findings that evidence a great interest for thyroid disorders just in the Medieval Medical School of Salerno (12th century). Rogerius Salernitanus, the Salernitan surgeon and author of "Post mundi fabricam" (around 1180) was considered at that time the surgical text par excellence all over Europe. In the chapter "De bocio" of his magnum opus, he describes several pharmacological and surgical cures, some of which nowadays are reappraised as scientifically effective. In modern times, the thyroid was first identified in 1656 by the anatomist Thomas Wharton (whose name is also eponymised in Wharton's duct of the submandibular gland). Thyroxine was identified only in the 19th century. In 1909, Theodor Kocher from Switzerland won the Nobel Prize in Medicine "for his work on the physiology, pathology and surgery of the thyroid gland"

THYROID DISORDERS

INTRODUCTION Hypo function - Hypothyroidism Hashimoto's thyroiditis / thyroiditis Ord's thyroiditis Postoperative hypothyroidism Postpartum thyroiditis Silent thyroiditis Acute thyroiditis Iatrogenic hypothyroidism Thyroid hormone resistance Euthyroid sick syndrome Hyper function - Hyperthyroidism Thyroid storm Graves' disease Toxic thyroid nodule Toxic nodular Struma (Plummer's disease) Hashitoxicosis

Nodular abnormalities - Goitre Endemic goitre Diffuse goitre Multinodular goitre Lingual thyroid Thyroglossal duct cyst Tumors Thyroid adenoma Thyroid cancer Papillary Follicular Medullary Anaplastic Lymphomas and metastasis

HYPERTHYROIDISM
increased thyroid hormone secretion leads to hyperthyroidism Sympathetic over activity
Restlessness, sweating, tremor, moist warm skin, fine hair, tachycardia (A. fib), weight loss, increased stool frequency, menstrual irregularities, hyperreflexia, osteoporosis, lid lag

HYPOTHYROIDISM

Etiology: Primary: Hashimotos thyroiditis with or without goiter Radioactive iodine therapy for Graves disease Subtotal thyroidectomy for Graves disease or nodular goiter Excessive iodine intake Sub acute thyroiditis Rare causes Iodide deficiency Goitrogens such as lithium; antithyroid drug therapy Inborn errors of thyroid hormone synthesis Secondary: Hypopituitarism Tertiary: Hypothalamic dysfunction (rare) Peripheral resistance to the action of thyroid hormone

Decreased thyroid hormone secretion leads to hypothyroidism

CAUSES
Cells damaged; no longer function Cells might be normal, person doesnt ingest enough iodide & tyrosine needed to make thyroid hormones

SYMPTOMS

Blood levels of thyroid hormones are low Decreased metabolic rate Hypothalamus and anterior pituitary gland make stimulatory hormones (TSH) as compensation Thyroid gland enlarges forming goiter The removal of the thyroid following surgery to treat severe hyperthyroidism and/or thyroid cancer