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1

What is iodine essential for?

The formation of the thyroid hormones

2

T4

Thyroxine

3

T3

Tri-iodothyronine

4

Why are they labeled T4 and T3?

They are numbered as these molecules contain four and three atoms of the element iodine respectively

5

What is the body's main dietary source of iodine? (3)

1. Seafood
2. Vegetables grown in iodine-rich soil
3. Iodinated table salt

6

What is the recommended minimum intake of iodine per day?

150ug/day

7

Iodine trapping

The thyroid gland selectively takes up iodine from the blood

8

What is the release of T4 and T3 into the blood stimulated by?

By the thyroid stimulating hormone
- TSH

9

Where is the TSH released from?

The anterior pituitary gland

10

What is secretion of TSH stimulated by?

Thyrotrophin releasing hormone
- TRH

11

Where is TRH released from?

The hypothalamus

12

What kind of feedback loop are the thyroid hormones involved with?

Negative feedback
- increase T3, decrease T4 (and vice versa)

13

How does T3 and T4 affect most cells of the body by? (3)

1. Increasing the basal metabolic rate
2. Increasing heat production
3. Regulating metabolism of carbohydrates, proteins and fats

14

What is T4 and T3 essential for?

Normal growth and development
- especially of the skeleton and nervous system

15

What is influenced by thyroid hormones?

Most other organs and systems
- heart, skeletal muscles, skin, digestive and reproductive systems

16

Hyperthyroidism

Increased levels of T3 and T4 secretions

17

What are the common effects of hyperthyroidism? (7)

1. Increased basal metabolic rate
2. Weight loss, good appetite
3. Anxiety, physical restlessness, mental excitability
4. Hair loss
5. Warm sweaty skin, heat, intolerance
6. Diarrhoea
7. Exophthalmos in Graves' disease

18

What factors affect the thyroid hormones? (6)

1. Exercise
- too much or too little
2. Diet
- malnutrition
3. Age
4. Stress
5. Low blood glucose
6. Lack of sleep

19

Exophthalmos

Bulging of the eyes in Graves' disease

20

Hypothyroidism

Decreased levels of T3 and T4 secretion

21

What are the common effects of hypothyroidism? (7)

1. Decreased basal metabolic rate
2. Weight gain, anorexia
3. Depression, psychosis, mental slowness, lethargy
4. Dry skin, brittle hair
5. Constipation
6. Bradycardia
7. Dry cold skin, prone to hypothermia

22

What is the first test for assessment of the thyroid function?

TSH
- thyroid stimulating hormone

23

What is the TSH test monitoring?

The patients who are on thyroid replacement or suppressive therapy

24

What is the good thing about patients on thyroid replacement or suppressive therapy?

They are more sensitive than free T4 to alterations of thyroid status in patients with primary thyroid disease

25

What is not part of the essential assessment to TSH?

Investigation of the thyroid function with T4
- monitoring patients on thyroid replacement therapy

26

What is elevated in hyperthyroidism?

Free T4

27

What are examples of thyroid function tests? (4)

1. TSH
2. T4
3. Antibodies
4. Elevated levels of anti-TPO antibodies

28

Antibody thyroid function test

Anti-TPO antibody
- marker for the diagnosis and management of autoimmune thyroid disease

29

Where do you see elevated levels of anti-TPO antibodies? (2)

1. Hashimotos thyroiditis
2. Graves' disease
- 85%

30

High levels of TSH leads to?

Hypothyroidism