Hypothyroidism and its Treatment
Disorders of thyroid hormone levels are one of the more commonly seen endocrine issues is patients.1 Thyroid hormones are synthesized in the thyroid gland and are then released at a rate of about 80 micrograms of T4, and 4 micrograms of T3 daily. Thyroid stimulating hormone (TSH), which is released from the anterior pituitary, is responsible for stimulating the release of thyroid hormones. In normal patients negative feedback of TSH would occur when the thyroid hormone blood levels were sufficient.
Once circulating, both T3 and T4 are more than 99 percent bound to the plasma proteins albumin, transthyretin, and thyroxine-binding globulin1. The more physiologically active form of thyroid hormone is the T3
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Due to her Hashimoto’s diagnosis JJ should begin pharmacologic treatment. The mainstay for treatment of hypothyroidism is levothyroxine4. Levothyroxine is synthetic T4 that comes in a variety of strengths and is a relatively cheap generic medication. Levothyroxine has a simple method of action, it replaces T4 hormone that the patient’s thyroid cannot produce and once in the blood stream acts just like natural T44. The starting dose for this medication is patient is under 50 years old is 1.6 mcg/kg daily4. JJ is currently 73 kg, so she should be started on the levothyroxine 112 mcg daily. When being counseled JJ should be told to take her medication once daily every morning 30 minutes before breakfast, this is because levothyroxine is best absorbed on an empty stomach and this environment is needed to get the full dose4. Although not preferred, if this method of taking her medication does not work for JJ she can take her one tablet daily 4 hours after her last meal of the day, or take her entire weekly dose once a week4. JJ should be told that the onset of action for levothyroxine is about 3-6 days; she could experience increased heart rate, weight loss, fever, or tremors5. Levothyroxine has some drug interactions that pertain to medications JJ is on. Levothyroxine and …show more content…
Available at: http://www.mayomedicallaboratories.com/test-catalog/Clinical and Interpretive/81765. Accessed January 26, 2016.
3. Jonklaas J, Talbert RL. Chapter 58. Thyroid Disorders. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey L. eds. Pharmacotherapy: A Pathophysiologic Approach, 9e. New York, NY: McGraw-Hill; 2014. http://accesspharmacy.mhmedical.com.ezproxy.ttuhsc.edu/content.aspx?bookid=689&Sectionid=45310510. Accessed January 26, 2016.
4. Pierini D. Thyroid Disorders Medication Therapy Management Data Set. In: Angaran DM, Whalen K. eds. Medication Therapy Management: A Comprehensive Approach. New York, NY: McGraw-Hill; 2015. http://accesspharmacy.mhmedical.com.ezproxy.ttuhsc.edu/content.aspx?bookid=1079&Sectionid=61425835. Accessed January 23, 2016.
5. Levothyroxine. Lexicomp. Wolters Kluwer Health, Inc. Hudson, OH. Available at: http://online.lexi.com.ezproxy.ttuhsc.edu/lco/action/doc/retrieve/docid/patch_f/7172#f_adverse-reactions. Accessed January 26, 2016
6. Pantalone KM, Hatipoglu BA. Hyponatremia and the Thyroid: Causality or Association?. J Clin Med.
Anne is a seventy-four year old female with multiple comorbidities. The patient I interviewed is a sixty five year old male with a past medical history of hypothyroidism and no other reported medical conditions. Additionally, Anne requires assistance with completing her activities of daily living such as shopping, transportation and managing her finances. Also she rarely leaves her home, and is inactive due to chronic pain. The patient I interviewed is able to care for himself independently and is rather active. The patient I interviewed continues to work outside his home and routinely
Is consider an autoimmune disorder, because elevated enzyme (TPO) Thyroid Peroxidase which are thyroid follicle cells iodinates T4 and T3. TPO ends up attacking it self, resulting in inflammation which ends up damaging the thyroid gland. Primary hypothyroidism is also known Hashimoto disease. The primary hypothyroidism lead to Margie’s symptoms trouble concentrating, puffier face, and hot flashes. Considering all the things above, Margie will be treated with Levonthyroxine a thyroid replacement hormone. This thyroid replacement hormone will first be introduce with a low those, there after it will increase until she reaches normal T4 and TSH levels. The negative result of this medication is the increased risk of developing osteoporosis. Therefore Margie should eat high calcium diet with calcium and vitamin D
CAH is an autosomal recessive genetic disorder and males and females are affected in equal numbers. Chromosome 6 is where the group of genes lie that causes the most common forms of CAH. Adrenocorticotropic hormones (ACTH) are released by the anterior lobe in the pituitary gland. Its role is to act on cells of the adrenal cortex which then synthesizes corticosteroids and cortisol. However, those with CAH have insufficient amounts of the enzyme 21-hydroxylase, needed to convert 17-hydroxyprogesterone (17-OHP) into cortisol.
United States. National Institute of Mental Health. “Mental Health Medications.” 2008. Health and Education. Web. 16 Nov. 2013
Graves’ disease is an autoimmune disease that was discovered by Robert Graves in 1835. Graves’ disease is an autoimmune disease in which the body's immune system attacks the thyroid gland and causes hyperthyroidism. Graves’ disease occurs when the antibodies like thyroid-stimulating immunoglobulin and thyrotropin receptor antibodies (TRAbs) attack the thyroid gland as if it were a foreign object or a virus of some sort. This disease is the most common type of hyperthyroidism. Attacking the thyroid gland in such a manner makes it excessively overproduce the hormone thyroxine which controls the body’s metabolic rate. Heightened activity of the thyroid can increase the body’s metabolism by 60% to 100%. (Weeks 34-35).
Today in America thyroid disease is becoming a much larger issue and the worse part of this problem is that many people are not yet diagnosed. This is due to the lack of education and awareness about thyroid disease. There are many different types of diseases but the one that I am passionate about is hypothyroidism. Hypothyroidism, or underactive thyroid is when the thyroid is no longer able to produce triiodothyronine, also known as T3 and thyroxine, also referred to as T4. Some of the symptoms include unexpected weight gain, tiredness, depression, or slow movements and thoughts. Most of the time many people notice the way that their bodies act on what they are feeling to their physicians. Many Americans struggle with this disease that
The following presentation will help this class in the teaching of a patient with hypothyroidism. The expected outcome of this presentation for the patient will be as follows:
Obtaining an ADHD prescription medication depends on a variety of factors. A consumer must have access to a provider with prescribing privileges and must be able to obtain any test necessary to determine the need for or appropr...
The thyroid is one of the most essential glands in the body. It is located in the endocrine system, and sits right in the neck just above where the collar bones meet. The thyroid gland functions to produce hormones that control how every cell in the body utilizes energy, also known as a process called metabolism. When a person's thyroid abnormally produces an excessive amount of thyroid hormones, this is a condition referred to as hyperthyroidism. The causes of hyperthyroidism are known to include: eating too much food with iodine, graves disease, inflammation due to viral infections, tumors of the testes and ovaries, taking a large amount of thyroid hormone, receiving medical imaging tests consisting of contrast dye iodine, and growth of thyroid or pituitary gland (Board "Hyperthyroidism"). With an overactive thyroid, the body tends to speed up its functions. Symptoms vary from, fast heartbeats, rapid weight loss, abnormal sweating, nervousness, and mood changes. Hyperthyroidism is normally diagnosed through a series of lab tests. If not properly taken care of, condition may worsen leading to bone and heart problems in the long run. As far as treatment is concerned, options may vary from person to person depending on age and the level of activity of the thyroid. Treatments include antithyroid medicines, radioactive iodine ablation, and the last resort, surgery. Though all treatment plans work, radioactive iodine ablation is a permanent and more reliable remedy for an overactive thyroid. Radioactive iodine ablation is in fact the most commonly used cure for people with hyperthyroidism problems in the US today. “The treatment has been around since 1942 and has been extensively used since the 1950's” ("Radioactive Iodine Treatment o...
The thyroid gland plays a major role in the endocrine, thyroxine, triiodothyronine and metabolism system. The gland can be found in the front of the neck and above where the collar bones meet. The thyroid gland controls the body by releasing T4 and T3 hormones. Controlling metabolism plays an important role when regulating mood, weight,
Andersson, Maria; Zimmermann, Michael B. (2010). Influence of Iodine Deficiency and Excess on Thyroid Function Tests 28. pp. 45–69
Thyroid cancer is one of the main conflicts in John Green’s novel, The Fault in Our Stars. Hazel Grace, the protagonist, has papillary thyroid cancer that has metastasized to the lungs. Her disease precludes her from carrying a healthy relationship with her love interest, Augustus Waters, and the reader sees how difficult it is to live a normal life with such a life-threatening disease as cancer. There are many different causes as to why people contract thyroid cancer even though it only accounts for 1% of all cancer in the United States (Sarge 1). Furthermore, there are four subtypes of thyroid cancer with different intensities: papillary, follicular, medullary, and anaplastic. Each type of thyroid cancer comes with a different type of treatment care such as chemotherapy, thyroidectomies, and hormone therapy (Sarge 2).
Polypharmacy is the “concurrent use of several differ drugs and becomes an issue in older adults when the high number of drugs in a medication regimen includes overlapping drugs for the same therapeutic effect”(Woo & Wynne, 2011, p. 1426). The patient is currently taking several medications that can potential interact with each other, perform the same therapeutic effect, and creating side effects. The following is a list of her medications and their indications:
... Medicine. 3rd ed. Vol.3. Detroit: Gale, 2006.2139-2141. Gale Virtual Reference Library. Web. 3 Apr. 2014.
Among these disorders are hypothyroidism and hyperthyroidism. Hypothyroidism is a disorder in which one is diagnosed for having and underactive thyroid. The probability for women over the age of sixty to develop an underactive thyroid is higher than those of other individuals. If left untreated it can potentially lead to obesity, joint pain, heart disease, and other health complications. On the contrary, hyperthyroidism is a disorder in which a person is diagnosed for having an overactive thyroid. This can cause nervousness and anxiety, hyperactivity, unexplained weight loss, and swelling of the thyroid gland which causes a noticeable lump to form on throat (known as a