Thyroid Disease - Biochemistry - Flashcards in University Medicine

Where is T4 secreted from?

Only from the thyroid

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Where is T3 secreted from?

It is produced peripherally via deionisation of T4

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Describe the hormone features of primary hypothyroidism

decreased free T4 and increased TSH due to the loss of -ve feedback

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What are the clinical features of primary hypothyroidism?

(THINK OF DECREASED METABOLISM Sx) lethargy, weight gain, cold intolerance, coarse hair and skin, slow reflexes, bradycardia, menstrual abnormalities, constipation

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How is primary hypothyroidism treated?

Thyroxine replacement - ideal replacement should normalise TSH and FT4 levels

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What are the potential problems with thyroxine replacement?

inadequate = increased TSH, decreased FT4 | over replacement = decreased TSH, increased FT4 (risk of AF and bone disease!!)

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What are the hormone features of primary hyperthyroidism?

increased FT4, increased FT3 => decreased TSH

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What are the clinical features of primary hyperthyroidism?

(THINK OF INCREASED METABOLISM Sx) weight loss, heat intolerance, palpitations, agitation, tremor, muscle weakness, diarrhoea, thyroid eye disease, menstrual abnorms

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How should you approach a patient who presents with normal FT3/FT4 but decreased TSH?

They may have transit thyroiditis or beginning of primary hyperthyroidism, so need to be re-checked 2 months later ALSO be wary that Tx for primary hyperthyroidism can take a while for the TSH the increase --> so do not over treat early on

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Thyroid Disease - Biochemistry

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