Endocrinology disease Dominika Karpińska
Description: Endocrinology disease Dominika Karpińska Hypothyroidism it is a state of insufficient supply of the body with thyroid hormones, which leads to a slowdown in development and metabolic processes, It can be caused by deficiency T4 orand T3 or
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slide1. Endocrinology disease Dominika Karpińska<br>
slide2. Hypothyroidism it is a state of insufficient supply of the body with thyroid hormones, which leads to a slowdown in development and metabolic processes,
It can be caused by deficiency T4 or/and T3 or deficiency TSH or/ and TRH ,
classification :
-congenital hypothyroidism,
-resulting from disorders of the development of the thyroid gland,
-acquired hypothyroidism due to external or autoimmune factors<br>
slide3. Hypothyroidism it is a state of insufficient supply of the body with thyroid hormones, which leads to a slowdown in development and metabolic processes,
It can be caused by deficiency T4 or/and T3 or deficiency TSH or/ and TRH ,
classification :
-congenital hypothyroidism,
-resulting from disorders of the development of the thyroid gland,
-acquired hypothyroidism due to external or autoimmune factors Symptoms:
feeling constantly cold,
fatigue/drowsiness depression,
memory disorders,
weight gain,
less frequent passing of stools/constipation,
slow heart rate,
low blood pressure,
dry flaky pale skin,
dry hair,
menstrual disorders,,
Infertility;<br>
slide4. Types of hypothyroidism in children Congenital Hypothyroidism:
This type arises when the thyroid gland fails to develop or function properly before birth.
It is a prevalent issue, impacting approximately 1 in every 2,500 to 3,000 newborns.
Congenital hypothyroidism is routinely screened for in all U.S. states during newborn assessments.
Determining whether the condition is hereditary, the severity at diagnosis, and the treatment's progress in the initial years guides decisions on potential lifelong therapy.
Autoimmune Hypothyroidism (Chronic Lymphocytic Thyroiditis):
Acquired hypothyroidism often stems from an autoimmune disorder known as chronic lymphocytic thyroiditis (CLT).
CLT involves the immune system attacking the thyroid gland, causing damage and reduced function.
Commonly referred to as Hashimoto’s thyroiditis, it is more prevalent in girls and adolescents, particularly those with other autoimmune conditions like insulin-dependent diabetes.
Approximately 20 to 30 percent of diabetics are at risk of developing CLT, necessitating regular screening.
Iatrogenic Hypothyroidism:
This form results from medically induced destruction or surgical removal of the thyroid gland.
The absence of the thyroid gland leads to a cessation in the production of thyroid hormone, resulting in iatrogenic hypothyroidism.
Central Hypothyroidism:
Central hypothyroidism occurs when the brain fails to produce thyroid-stimulating hormone (TSH), responsible for signaling the thyroid to function.
Unlike disorders related to an abnormal thyroid gland, central hypothyroidism is less common, and patients often exhibit normal thyroid function.
In addition to low TSH levels, central hypothyroidism may involve deficiencies in other hormones, impacting various bodily functions.
Causes include abnormal development of the hypothalamus or pituitary glands, trauma, tumors, or treatments such as surgery or radiation.
It may also be inherited, affecting both boys and girls equally.<br>
slide5. Management of Hypothyroidism Synthetic thyroid hormone, levothyroxine (L-T4), is commonly used for hypothyroidism treatment.
Administered orally in the morning on an empty stomach, at least 30 minutes before the first meal.
Factors affecting absorption include pH levels in the stomach and interactions with food, medications, and fluids.
Dosage depends on clinical condition and patient age.
Initiate treatment with a small dose, gradually adjusting based on clinical presentation and TSH levels.
Younger individuals may experience faster dose escalation, reaching the target dose within weeks.
Regular monitoring of TSH levels and clinical symptoms guides effective management.<br>
slide6. Hyperthyroidism - is a disorder in which the thyroid gland produces too much hormone than the body needs Etiology:
Graves’ disease (GD),
autoimmune neonatal hyperthyroidism
acute or subacute thyroiditis,
chronic lymphocytic thyroiditis (Hashimoto’s disease),
Exogenous causes - exogenous thyroid hormone, iodine-induced hyperthyroidism (iodine, radiocontrast agents, amiodarone),
autonomous functioning nodules
acute or chronic administration of thyroid hormones and/or iodides,
McCune-Albright syndrome ,
germline and somatic gain-of-function mutations of the TSH receptor gene, as are TSH-secreting pituitary tumours,
thyroid hormone resistance;<br>
slide7. GD the cause of GD remains unclear,
result from a complex interaction between genetic background, environmental factors and the immune system,
for unknown reasons, the immune system produces an antibody [TSH receptor antibody (TRAb)] that stimulates the thyroid gland to produce excess thyroid hormone;<br>
slide8. Symptoms Fatigue and/or Reduced Exercise Tolerance
Slower Reaction Time, Particularly Crucial for Drivers
Weight Gain
Constipation
Sparse, Coarse, and Dry Hair
Coarse, Dry, and Thickened Skin
Slow Pulse
Cold Intolerance Muscle Cramps
Thinning or Loss of Eyebrow Hair on the Sides
Dull Facial Expression
Hoarse Voice
Slow Speech
Drooping Eyelids
Puffy and Swollen Face
Enlarged Thyroid, Resulting in a Goiter-like Growth on the Neck
Increased Menstrual Flow and Cramping in Girls and Young Women<br>
slide9. Treatment pharmacological treatment with antithyroid drugs (thyrostatic agents). Antithyroid medications include thiamazole and propylthiouracil. Thyrostatic agents inhibit the production of hormones in the thyroid gland and their effect becomes visible after approximately 2-4 weeks of use,
treatment with radioactive iodine (131I) - oral, single administration of radioactive iodine aims to slowly, irreversibly damage the thyroid cells that actively capture iodine from the blood. The effect of radioactive iodine develops within a few months after therapy,<br>
slide10. Treatment surgical treatment (strumectomy, thyroidectomy). This form of therapy is absolutely recommended in cases of suspected or diagnosed thyroid cancer, including those coexisting with hyperthyroidism, additionally, surgical treatment is considered in patients with a large goiter compressing the trachea. After surgery to remove the thyroid gland, hypothyroidism occurs, which requires constant treatment with thyroxine preparations.<br>
slide11. Hashimoto's disease Hashimoto's disease known as chronic autoimmune thyroiditis, is inflammation of the thyroid gland caused by a malfunction of the immune system.
Symptoms can be divided into local ones (related to the size of the thyroid gland) and those related to thyroid hormone deficiency.
At the beginning of the disease, the thyroid gland may be enlarged (goiter). As it progresses, the thyroid gland becomes smaller and smaller and nodules may appear. Chronic lymphocytic inflammation does not usually cause neck pain in the thyroid area.
The main symptoms indicating hypothyroidism are:
- constant feeling of cold,
- fatigue/drowsiness,
- depression,
- memory disorders,
- weight gain,
- less frequent passing of stools/constipation,
- slow heart rate, low blood pressure,
- dry, flaky, pale skin, dry hair,
- menstrual disorders, infertility.<br>
slide12. Sourses https://www.hopkinsmedicine.org/health/conditions-and-diseases/hypothyroidism-in-children
https://www.chop.edu/conditions-diseases/hypothyroidism
https://www.mp.pl/pacjent/endokrynologia/choroby/78398,nadczynnosc-tarczycy
Niedoczynność tarczycy. Bolanowki M. Lekarz POZ 2026 (3), 189-192
J Clin Res Pediatr Endocrinol. 2013 Mar; 5(Suppl 1): 50–56 Hyperthyroidism in Childhood: Causes, When and How to Treat<br>
slide2. Hypothyroidism it is a state of insufficient supply of the body with thyroid hormones, which leads to a slowdown in development and metabolic processes,
It can be caused by deficiency T4 or/and T3 or deficiency TSH or/ and TRH ,
classification :
-congenital hypothyroidism,
-resulting from disorders of the development of the thyroid gland,
-acquired hypothyroidism due to external or autoimmune factors<br>
slide3. Hypothyroidism it is a state of insufficient supply of the body with thyroid hormones, which leads to a slowdown in development and metabolic processes,
It can be caused by deficiency T4 or/and T3 or deficiency TSH or/ and TRH ,
classification :
-congenital hypothyroidism,
-resulting from disorders of the development of the thyroid gland,
-acquired hypothyroidism due to external or autoimmune factors Symptoms:
feeling constantly cold,
fatigue/drowsiness depression,
memory disorders,
weight gain,
less frequent passing of stools/constipation,
slow heart rate,
low blood pressure,
dry flaky pale skin,
dry hair,
menstrual disorders,,
Infertility;<br>
slide4. Types of hypothyroidism in children Congenital Hypothyroidism:
This type arises when the thyroid gland fails to develop or function properly before birth.
It is a prevalent issue, impacting approximately 1 in every 2,500 to 3,000 newborns.
Congenital hypothyroidism is routinely screened for in all U.S. states during newborn assessments.
Determining whether the condition is hereditary, the severity at diagnosis, and the treatment's progress in the initial years guides decisions on potential lifelong therapy.
Autoimmune Hypothyroidism (Chronic Lymphocytic Thyroiditis):
Acquired hypothyroidism often stems from an autoimmune disorder known as chronic lymphocytic thyroiditis (CLT).
CLT involves the immune system attacking the thyroid gland, causing damage and reduced function.
Commonly referred to as Hashimoto’s thyroiditis, it is more prevalent in girls and adolescents, particularly those with other autoimmune conditions like insulin-dependent diabetes.
Approximately 20 to 30 percent of diabetics are at risk of developing CLT, necessitating regular screening.
Iatrogenic Hypothyroidism:
This form results from medically induced destruction or surgical removal of the thyroid gland.
The absence of the thyroid gland leads to a cessation in the production of thyroid hormone, resulting in iatrogenic hypothyroidism.
Central Hypothyroidism:
Central hypothyroidism occurs when the brain fails to produce thyroid-stimulating hormone (TSH), responsible for signaling the thyroid to function.
Unlike disorders related to an abnormal thyroid gland, central hypothyroidism is less common, and patients often exhibit normal thyroid function.
In addition to low TSH levels, central hypothyroidism may involve deficiencies in other hormones, impacting various bodily functions.
Causes include abnormal development of the hypothalamus or pituitary glands, trauma, tumors, or treatments such as surgery or radiation.
It may also be inherited, affecting both boys and girls equally.<br>
slide5. Management of Hypothyroidism Synthetic thyroid hormone, levothyroxine (L-T4), is commonly used for hypothyroidism treatment.
Administered orally in the morning on an empty stomach, at least 30 minutes before the first meal.
Factors affecting absorption include pH levels in the stomach and interactions with food, medications, and fluids.
Dosage depends on clinical condition and patient age.
Initiate treatment with a small dose, gradually adjusting based on clinical presentation and TSH levels.
Younger individuals may experience faster dose escalation, reaching the target dose within weeks.
Regular monitoring of TSH levels and clinical symptoms guides effective management.<br>
slide6. Hyperthyroidism - is a disorder in which the thyroid gland produces too much hormone than the body needs Etiology:
Graves’ disease (GD),
autoimmune neonatal hyperthyroidism
acute or subacute thyroiditis,
chronic lymphocytic thyroiditis (Hashimoto’s disease),
Exogenous causes - exogenous thyroid hormone, iodine-induced hyperthyroidism (iodine, radiocontrast agents, amiodarone),
autonomous functioning nodules
acute or chronic administration of thyroid hormones and/or iodides,
McCune-Albright syndrome ,
germline and somatic gain-of-function mutations of the TSH receptor gene, as are TSH-secreting pituitary tumours,
thyroid hormone resistance;<br>
slide7. GD the cause of GD remains unclear,
result from a complex interaction between genetic background, environmental factors and the immune system,
for unknown reasons, the immune system produces an antibody [TSH receptor antibody (TRAb)] that stimulates the thyroid gland to produce excess thyroid hormone;<br>
slide8. Symptoms Fatigue and/or Reduced Exercise Tolerance
Slower Reaction Time, Particularly Crucial for Drivers
Weight Gain
Constipation
Sparse, Coarse, and Dry Hair
Coarse, Dry, and Thickened Skin
Slow Pulse
Cold Intolerance Muscle Cramps
Thinning or Loss of Eyebrow Hair on the Sides
Dull Facial Expression
Hoarse Voice
Slow Speech
Drooping Eyelids
Puffy and Swollen Face
Enlarged Thyroid, Resulting in a Goiter-like Growth on the Neck
Increased Menstrual Flow and Cramping in Girls and Young Women<br>
slide9. Treatment pharmacological treatment with antithyroid drugs (thyrostatic agents). Antithyroid medications include thiamazole and propylthiouracil. Thyrostatic agents inhibit the production of hormones in the thyroid gland and their effect becomes visible after approximately 2-4 weeks of use,
treatment with radioactive iodine (131I) - oral, single administration of radioactive iodine aims to slowly, irreversibly damage the thyroid cells that actively capture iodine from the blood. The effect of radioactive iodine develops within a few months after therapy,<br>
slide10. Treatment surgical treatment (strumectomy, thyroidectomy). This form of therapy is absolutely recommended in cases of suspected or diagnosed thyroid cancer, including those coexisting with hyperthyroidism, additionally, surgical treatment is considered in patients with a large goiter compressing the trachea. After surgery to remove the thyroid gland, hypothyroidism occurs, which requires constant treatment with thyroxine preparations.<br>
slide11. Hashimoto's disease Hashimoto's disease known as chronic autoimmune thyroiditis, is inflammation of the thyroid gland caused by a malfunction of the immune system.
Symptoms can be divided into local ones (related to the size of the thyroid gland) and those related to thyroid hormone deficiency.
At the beginning of the disease, the thyroid gland may be enlarged (goiter). As it progresses, the thyroid gland becomes smaller and smaller and nodules may appear. Chronic lymphocytic inflammation does not usually cause neck pain in the thyroid area.
The main symptoms indicating hypothyroidism are:
- constant feeling of cold,
- fatigue/drowsiness,
- depression,
- memory disorders,
- weight gain,
- less frequent passing of stools/constipation,
- slow heart rate, low blood pressure,
- dry, flaky, pale skin, dry hair,
- menstrual disorders, infertility.<br>
slide12. Sourses https://www.hopkinsmedicine.org/health/conditions-and-diseases/hypothyroidism-in-children
https://www.chop.edu/conditions-diseases/hypothyroidism
https://www.mp.pl/pacjent/endokrynologia/choroby/78398,nadczynnosc-tarczycy
Niedoczynność tarczycy. Bolanowki M. Lekarz POZ 2026 (3), 189-192
J Clin Res Pediatr Endocrinol. 2013 Mar; 5(Suppl 1): 50–56 Hyperthyroidism in Childhood: Causes, When and How to Treat<br>