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Benjamin Bujanda , M.D. Family Practice, Industrial Medicine, and Allergy Clinic McAllen, Texas 956-682-8343. HYPERthyroidism & HYPOthyroidism. HYPERthyroidism is the medical term for a condition when the thyroid gland has greater than normal activity
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Benjamin Bujanda, M.D. Family Practice, Industrial Medicine, and Allergy Clinic McAllen, Texas 956-682-8343 HYPERthyroidism & HYPOthyroidism
HYPERthyroidism is the medical term for a condition when the thyroid gland has greater than normal activity The thyroid is regulated by the pituitary gland Excessive production of thyroid hormones, thyroxine (T4) and triiodothyronine (T3), results in HYPERthyroidism which creates an enlargement of the thyroid gland located in the neck at the base of the throat It is part of the endocrine system that also includes pituitary gland, pancreas, adrenal, and ovaries or testicles Disturbances of thyroid growth and function are among the most common endocrinologic disorders encountered in practice with HYPOthyroidism being the most common HYPOthyroidism results when there is a deficiency in hormone production from the thyroid Thyroid hormone deficiency may effect almost all body functions HYPOthyroidism may be due to primary disease of the thyroid gland itself or lack of pituitary TSH General Information
Increased irritability/difficulty concentrating Anxiety Change in weight Fatigue Rapid heart rate, irregularities in heart rhythm, chest pain Shaky hands, diarrhea, vomiting, nausea, abdominal pain Increased sweating, sensations of warmth/heat intolerance Warm moist skin Increased appetite with weight loss Increased urination, decreased sexual activity, menstrual irregularities Bulging eyes, weakness, headaches, bursitis Enlarged thyroid Loose stools Symptoms of HYPERthyroidism
Decreased libido • Cardiovascular difficulties • Harder than normal beats • Rapid heart rate with atrial fibrillations • Chest pain • Impotence • Gynecomastia in men HYPERthyroidism complications
Symptoms of HYPOthyroidism • Constipation • Weakness • Depression • Fatigue • Weight Gain • Cold Intolerance • Heavy menstrual flow (menorrhagia) • Husky Voice • Carpal tunnel syndrome • Hair Loss • Psychosis/Dementia • Apathy • Headaches • Joint pain • Muscle spasm • Brittle hair and nails
Laboratory tests can confirm or deny existence of HYPERthyroidism or HYPOthyroidism by determine the amount of hormones produced Diagnosis
TSH is increased, first indication of primary HYPOthyroidism • HYPERthyroidism refers to increased T4 or T3 and HYPOthyroidism refers to decrease T4 or T3 • Some drugs can induce HYPOthyroidism • Lithium- used for manic depression • Sulfomamides- used for infections Laboratory findings
Signs of HYPOthyroidism • Skin • Decrease sweating • Dry skin • Periorbital edema • Myxedema • Raynaud’s phenomenon • Macroglosia • Carotenemia • Cardiac • Bradycardia (slow heart rate below 60) • Congestive Heart Failure • Cardomyopathy • Pleural effusion • Ascites • Laboratory • Increased TSH and T4 • Anemia • Cholesterol Level high • Increased Lipidemia • Increased Uric acid level • Increased Calcium level • Decreased Sodium level • Increased liver function tests • SGOT • SGPT • LDH • Neurological • Coma • Carpal Tunnel
Depressed or Mental Confusion Decreased sex drive Irregular menstrual cycles Mostly cardiac in nature Poor circulation Increased susceptibility to infection Heart disease- too much plaque HYPOthyroidism Complications
Can be monitored by following the serum TSH every 6 months to a year • Drugs- using prescribed medication properly, 50% of patients have no recurrence of the disorder after medication is discontinued • Levothyroxine (thyroxine)- HYPOthyroidism • Propranolol- HYPERthyroidism • Thiourea drugs- HYPERthyroidism • For HYPERthyrodism radioactive Iodine treatments- 75% of patients can be effectively treated using less time and money than surgery, but there are restrictions • Very young children should use this treatment • Pregnant women should not use this treatment • 10-15% result in HYPOthyroidism permanently (low thyroid output) and must use replacement medications for life • Surgery- removal of the gland with replacement medication for life Thyroid Treatments
Medical Conditions • Viral infections • Pregnancy • Auto-immune disease • Age- usually over 60 • Gender- women are more likely to have it • Heredity- family history • Ethnic- Orientals Risk factors of HYPOthyroidism
Heart Palpitations Chronic Constipation Unusual Sweating/heat intolerance Involuntary Tremors Problems with Menstrual Cycles Recurring infection Increased Weight Gain Any of the other symptoms appear When to call the doctor
GOOGLE: HYPERthyroidism or HYPOthyroidism American Association of Clinical Endocrinologists at: http://www.aace.com/ American Women’s Medical Association website at: http://www.amwa-doc.org Thyroid disease website at: http://www.bio.davidson.edu/Courses/Immunology/Students/Spring2003/Breedlove/GravesDisease.html WEbsites
This slide presentation can be found at Dr. Bujanda’s website benjaminbujandamd.com Benjamin Bujanda’s website
Benjamin Bujanda, M.D. Family Practice, Industrial Medicine, and Allergy Clinic McAllen, Texas 956-682-8343 QUESTIONS & ANSWERS