8) An endocrine case A woman seeks medical advice because she feels tired and listless. She also complains of gaining weight in the past year, although her appetite has decreased. Her friends have also commented that she seems low, or even depressed. When the doctor examines her, she measures a heart rate of 60 beats / minute, which is a little lower than normal, swollen face and dry, brittle hair. During the examination, she gets cold and freezes even if the temperature around is normally warm. The doctor suspects hypothyroidism, but before a final diagnosis she needs some information, including some blood tests. The results show high cholesterol levels, which is usually seen in hypothyroidism, extremely low thyroid hormone levels and high levels of TSH. These results showed that the woman suffered from a problem with the thyroid gland and not from the pituitary gland. Further tests showed that the woman had an autoimmune disease, Hashimoto's disease in which the thyroid follicle cells are destroyed by the immune system. Questions: 1. What is TSH and what does it do? Why were the levels so high? 2. What would have been the indication if the woman's TSH levels had been low?
8) An endocrine case A woman seeks medical advice because she feels tired and listless. She also complains of gaining weight in the past year, although her appetite has decreased. Her friends have also commented that she seems low, or even depressed. When the doctor examines her, she measures a heart rate of 60 beats / minute, which is a little lower than normal, swollen face and dry, brittle hair. During the examination, she gets cold and freezes even if the temperature around is normally warm. The doctor suspects hypothyroidism, but before a final diagnosis she needs some information, including some blood tests. The results show high cholesterol levels, which is usually seen in hypothyroidism, extremely low thyroid hormone levels and high levels of TSH. These results showed that the woman suffered from a problem with the thyroid gland and not from the pituitary gland. Further tests showed that the woman had an autoimmune disease, Hashimoto's disease in which the thyroid follicle cells are destroyed by the immune system. Questions: 1. What is TSH and what does it do? Why were the levels so high? 2. What would have been the indication if the woman's TSH levels had been low? What kind of treatment do you think the woman needs? How long do you think she will need treatment?
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