Thyroid Exam Notes PDF

 Free T4 (FT4): Low. This is the portion of T4 that is not bound to proteins and is available to enter tissues3.  Triiodothyronine (T3): Low. T3 is the active form of thyroid hormone4. Hyperthyroidism  Thyroid-Stimulating Hormone (TSH): Low. When thyroid hormone levels are hi...

 Free T4 (FT4): Low. This is the portion of T4 that is not bound to proteins and is available to enter tissues3.  Triiodothyronine (T3): Low. T3 is the active form of thyroid hormone4. Hyperthyroidism  Thyroid-Stimulating Hormone (TSH): Low. When thyroid hormone levels are high, the pituitary produces less TSH3.  Thyroxine (T4): High. T4 levels are elevated in hyperthyroidism4.  Free T4 (FT4): High. This indicates an excess of unbound T43.  Triiodothyronine (T3): High. T3 levels are elevated in hyperthyroidism4. 48. Know MOA for Levothyroxine Synthetic form of the T4 produced by the body. Will restore thyroid hormone levels in body. 49. Di erentiate between hypothyroidism, hyperthyroidism, euthyroidism and subclinical hypothyroidism Hypothyroidism  Definition: A condition where the thyroid gland is underactive, producing insu icient thyroid hormones.  Symptoms: Fatigue, weight gain, cold intolerance, dry skin, and increased risk of heart problems(Drugda et al., 2023).  Biochemical Markers: Low levels of thyroxine (T4) and elevated thyroid-stimulating hormone (TSH) levels(Drugda et al., 2023). Hyperthyroidism  Definition: A condition characterized by an overactive thyroid gland, producing excessive thyroid hormones.   Symptoms: Weight loss, heat intolerance, increased appetite, and anxiety. It may also present with myxedema, a condition typically associated with hypothyroidism(Sciacchitano et al., 2024).  Biochemical Markers: Elevated levels of thyroid hormones (T3 and T4) and suppressed TSH levels(Hirano et al., 2024). Euthyroidism  Definition: A state of normal thyroid function where the thyroid gland produces adequate amounts of hormones.  Biochemical Markers: Normal levels of thyroid hormones and TSH, indicating balanced thyroid function(Sciacchitano et al., 2024). Subclinical Hypothyroidism  Definition: A mild form of hypothyroidism where TSH levels are elevated, but thyroid hormone levels remain within the normal range(Jassim & Al-Jubory, 2024) (Drugda et al., 2023).  Symptoms: Often asymptomatic, but can be associated with an increased risk of coronary heart disease(Drugda et al., 2023).  Prevalence and Management: Commonly diagnosed in older adults, with spontaneous normalization in many cases. Treatment is debated, especially in the elderly, due to potential overtreatment risks(Ruderich & Feldkamp, 2022). 50. Monitoring hypothyroidism treatment Checking TSH every 6-8 weeks 51. Dosing hypothyroidism medication in special populations such as elderly and pregnancy Pediatrics a. Screening at birth i. Treatment with L4 ii. Newborn dose 10-17mcg/kg/day iii. 6 months 5-7 mcg/kg/day iv. 1 – 10 years 3-6 mcg/kg/day v. > 12 years adult dosing b. Acquired hypothyroidism often caused by autoimmune thyroiditis Geriatric i. Increased incidence ii. More prone to ADE 1. Start with a low dose and titrated a. Symptom improvement b. TSH –goal is the higher end of normal Pregnancy c. Untreated i. Miscarriage ii. Preterm delivery  iii. Maternal hypertension iv. Preeclampsia v. LBW vi. Still birth vii. Child, impaired intellectual development d. If treated prior to pregnancy, increase the dose by 20-50% to maintain TSH