Response to peers

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. Respond to at least two of your classmates. Participate in the discussion by analyzing each response for completeness and accuracy and by suggesting specific additions or clarifications for improving the discussion question response

Saralyn Goff posted Sep 10, 2020 7:25 PM

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Our patient presents with hypothyroid signs and symptoms. Hypothyroidism consists of a loss of thyroid function which leads to a decrease in the production of TH and increased secretion of TRH and TSH. The thyroid hormone is a necessity for normal growth and development and for regulation of metabolism in the adult. Body weight and energy expenditure are directly related to the thyroid hormone. Hypothyroidism is associated with hypometabolism which correlates with weight gain, decreased energy expenditure, decreased gluconeogenesis and lipolysis, and also increased levels of cholesterol. The thyroid hormone regulates the body’s metabolism through the brain, brown and white fat, skeletal muscle, the pancreas and the liver. TH stimulates the basal metabolic rate by increasing the production of ATP and generating ion gradients. The TH stimulates two ion gradients which include sodium and potassium across the membrane of the cell and calcium between the reticulum and cytoplasm. Patients with hypothyroidism, such as Shirley, have cold intolerance. The TH and SNS are necessary for maintaining core body temperature (Mullur, Liu, & Brent, 2014).

As the thyroid stimulation hormone levels rise, it impacts the negative feedback mechanism in the body. TSH is generally the first line test for patients with suspected thyroid problems. The TSH hormone is a glycoprotein hormone produced by the anterior pituitary. In primary hypothyroidism, the thyroid is unable to produce the proper amount of T3 and T4 which then leads to a loss of negative feedback inhibition and increased production of TSH. On the other hand, in secondary hypothyroidism, the anterior pituitary produces low levels of TSH and causes T3 and T4 levels to go down also. Neurons in the hypothalamus secrete TRH. TRH stimulates cells to secrete TSH. TSH then binds to receptors in the thyroid gland which leads to synthesis and secretion of thyroid hormones. This action affects all cells within the body. When the concentration of blood of thyroid hormones begin to increase, TRH secreting neurons are inhibited and then stops secreting TRH which is known as negative feedback (Pirahanchi, 2020).

Triiodothyronine (T3) and thyroxine (T4) are two important hormones that are produced by the thyroid gland. T3 and T4 are essential for the physical development and brain development in infants and for the metabolic activity in adults. These specific hormones help several major body organs to function properly. The thyroid gland takes iodine found in a person’s diet and begins to combine it with tyrosine which converts it to T3 and T4. The thyroid gland is in charge of the sole production of T4. Both of these hormones play a huge role in regulating energy levels, weight, internal body temperature, hair, skin, and nail growth, metabolism, and also regulating a person’s heart rate. The T3 hormone mainly binds to protein (Darwish & Lui, 2019).

Darwish, A., & Lui, F. (2019). Physiology, Colloid Osmotic Pressure. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK541067

Mullur, R., Liu, Y., & Brent, G. (2014). Thyroid hormone regulation of metabolism. Physiological reviews, 94(2), 355–382. Retrieved from https://doi.org/10.1152/physrev.00030.2013

Pirahanchi, Y. (2020). Physiology, Thyroid Stimulating Hormone. TSH. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK499850/

question #2

Lydia Scott posted Sep 10, 2020 11:03 PM

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Thyroid hormone (TH) is essential for the development and function of virtually all human tissues (Medici et. al 2017). The thyroid releases two hormones named triiodothyronine (T3) and thyroxine (T4) which effects the body’s metabolism along with other body systems such as cardiovascular, gastrointestinal, neurological, and nervous system to name a few. According to (Medici et. al 2017), “It is estimated that 45–65% of the total variation in thyroid function is determined by genetic factors, while the rest of the variation is thought to be due to environmental factors (e.g., iodine status) and individual characteristics (e.g., age and BMI).” Disorders of thyroid function develop because of primary dysfunction or disease of the thyroid gland or, secondarily, because of pituitary or hypothalamic alterations (McCance 2018). Shirley is displaying some of the symptoms related to diagnosing Hypothyroidism such as fatigue with low heart rate of 58 (cardiovascular), constipation (gastrointestinal), slow speech, lose of memory and deepening of her voice (neurological).

When T4 enters the circulation, it gets converted to T3 through the process of deiodination. T4 and T3 can then exert negative feedback on TSH levels (high levels of T3/T4 decrease TSH release from the anterior pituitary, while low levels of T3/T4 increase TSH release) (Pirahanchi 2020).

If there are not enough thyroid hormones in the bloodstream, the hypothalamus will signal the pituitary gland (via TRH) to produce TSH for the thyroid to release more T3 and T4 (Wannissorn 2019). T3 is suggested to lower the sensitivity of the part of the brain that makes hypothyroid test subjects anxious (Wannissorn 2019). More T4 in the body corresponds to less severe anxiety. This can be the cause of Shirley requiring the prescription of alprazolam.

McCance K., L., & Huether, S., E. (2018). Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th ed.) St Louis, MO: Mosby Inc; ISBN-13: 978-0323583473

Medici, M., Visser, T., & Peeters, R. (2017, April 18). Genetics of thyroid function. Retrieved September 11, 2020, from https://www.sciencedirect.com/science/article/pii/S1521690X17300301

Pirahanchi, Y. (2020, June 28). Physiology, Thyroid Stimulating Hormone (TSH). Retrieved September 11, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK499850/

Wannissorn, N. (2019, December 17). Thyroid Hormones (T3, T4): Roles, Functions, High/Low Levels. Retrieved September 11, 2020, from https://selfhacked.com/blog/thyroid-hormones-t4t3

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