Case Study, Diabetes, Final Version

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Ashton Alexander Professor McFarlane BIOS 252 December 17, 2023 Case Study: Thyroid What does the thyroid and its associated hormones do? The thyroid gland is the largest adult gland to have a purely endocrine function, weighing about 25 grams (Saladin et al., 2021) . This butterfly-shaped gland is wrapped around the trachea, with two wing-like lobes usually joined inferiorly to form a narrow bridge. This gland plays an integral role in regulating the body’s metabolism by producing hormones, primarily thyroxine (T3) and triiodothyronine (T4), which are the components that make up the “thyroid hormone.” What is a goiter? A goiter is the irregular growth of the thyroid gland (Mayo Clinic, 2021) . This irregular growth results in an expansion of the thyroid gland well beyond its typical size and manifests as a noticeable bulge in the neck. There are cases when both Hyperthyroidism and Hypothyroidism could present with a goiter. Why? For starters, hyperthyroidism is an overactive thyroid, while hypothyroidism is an underactive thyroid. In both of these conditions, there have been incidences of goiter development. In hyperthyroidism, there is an excessive production and demand of thyroid hormones. Because the thyroid gland is stimulated more than normal to release its hormones, it results in hypertrophy
and hyperplasia― which is the increase in cell size and count (Susan et al., 2016) . With this persistent growth and enlargement of the gland, a goiter forms. With hypothyroidism, there are decreased levels of thyroid hormone secretion, typically caused by iodine deficiency, a component needed for thyroid hormone production. Subsequently, the pituitary gland will try to compensate for the decrease in thyroid hormone by sending too much TSH (thyroid stimulating hormone) to stimulate the gland, which also leads to hypertrophy of the gland, known as goiter. Do you believe that she is presenting with hyperthyroidism or hypothyroidism? Why? The patient’s symptoms, such as having an abundance of energy and a desire for less sleep, are all signs of hyperthyroidism. The reason I say this is because the thyroid hormones control the way the body uses energy, so they affect nearly every organ in our body, even the way our heart beats (NIDDK, 2021) . So, if a person has too much thyroid hormone, many of your body’s functions speed up. Too much TH causes high energy, similar to the effects after drinking a cup of coffee. Other notable symptoms that this patient experienced were intolerance to heat, which is also related to hyperthyroidism. You suspect Grave's disease. What sign made you jump to this conclusion? Graves’ disease is an autoimmune disorder in which the immune system mistakenly attacks the thyroid gland, leading to excessive production of thyroid hormones (hypothyroidism). The same antibodies that attack the thyroid gland can target receptors on the sauce of tissues behind the eye, causing Graves’ ophthalmopathy (HealthMatch, 2022). When these tissues behind the eye suffer an attack, this results in exophthalmos (eye bulge) and blurred vision due to the inflammation from the self-attacks, both of these things the patient was experiencing, which made it ever so clear that she had Graves’ disease.
References Can AS, Rehman A. Goiter. (2023). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK562161/ HealthMatch. (2022). Hyperthyroidism And Your Eyes: What You Need to Know. https://healthmatch.io/hyperthyroidism/hyperthyroidism-symptoms-eyes Mayo Clinic. (2021). Goiter. https://www.mayoclinic.org/diseases-conditions/goiter/symptoms- causes/syc-20351829 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2021). Hyperthyroidism (Overactive Thyroid). https://www.niddk.nih.gov/health-information/endocrine-diseases/hyperthyroidism#:~:te xt=Thyroid%20hormones%20control%20the%20way Saladin, S. K., Gan, A. C., & Cushman, N. H. (2021). Anatomy & physiology: The unity of form and function. McGraw-Hill Education. Susan E. Orosz, Deborah Monks, Ricardo de Matos. (2016). Clinical Endocrinology of Protein Hormones . W.B. Saunders. https://doi.org/10.1016/B978-1-4557-4671-2.00019-7.
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