PULSE October 28, 2009 Pennsylvania State College of Medicine Nicolai Wohns

Hyperthyroidism also Hypothyroidism

Thyroid Function? Thyroid: Θυροειδής Shield: θυρεός

Metabolism

Growth

Development

Hyperthyroidism: Common symptoms and signs Heat intolerance Weight loss (with increased appetite) Easily fatigued (but with insomnia) Trembling hands Hard, irregular heartbeat (palpitations) Irritable, nervousness

Severe cases Shortness of breath Chest pain Muscle weakness Causes?

Grave’s Disease

Grave’s Disease: Common symptoms and signs Fatigue Weight loss with increased appetite other symptoms of hyperthyroidism Exophthalmos Non-pitting edema

Exophthalmos / Proptosis

Non-pitting Edema Causes? Pretibial Myxedema

Another autoimmune disorder…

Hashimoto’s thyroiditis Hyperthyroidism vs Hypothyroidism

Hashimoto’s?

Hypothyroidism: Common symptoms and signs Heat intolerance Weight loss (with increased appetite) Easily fatigued (but with insomnia) Trembling hands Hard, irregular heartbeat (palpitations) Irritable, nervousness Sensitivity to cold Weight gain Fatigue Goiter Bradycardia, Tachycardia Depression, mania, panic attacks Hyperthyroidism

Treatment

Treatment : Grave’s Disease Antithyroid drugs Radioiodine: radioactive iodine-131 Surgery: thyroidectomy

Treatment : Hashimoto’s Disease T4 supplementation synthetic L-T4; standard treatment T4 and T3 in combination both synthetic L-T4 and L-T3 simultaneously Desiccated Thyroid Extract Pig thyroid extract: natural forms of L-T4 and L-T3