Hypothyroidism Secondary: Symptoms, Treatment, DiagnosisDefinitionWhat is Hypothyroidism Secondary? Show
Secondary hypothyroidism involves decreased activity of the thyroid caused by failure of the pituitary gland. Alternative Names: Pituitary hypothyroidism Causes, incidence, and risk factors:The thyroid gland is an important organ of the endocrine system, located in the front of the neck just below the voicebox. The thyroid secretes the hormones thyroxine (T4), triiodothyronine (T3), and calcitonin, which control body metabolism and regulate calcium balance. The secretion of T3 and T4 by the thyroid is controlled by an endocrine feedback system involving the pituitary gland and the hypothalamus (structures in the brain). Lowered levels of these thyroid hormones result in increased levels of pituitary and hypothalamic hormones. The reverse is also true -- when levels of the thyroid hormones rise, pituitary and hypothalamic hormones fall back. This helps keep levels appropriately balanced. Since the thyroid gland is regulated by the pituitary gland and the hypothalamus, thyroid disorders may result not only from defects in the thyroid itself but also from the disruption of the control system in these other organs. Thyroid disorders caused by overproduction of thyroid hormones are called hyperthyroidism, and underproduction of these hormones is known as hypothyroidism. The cause of secondary hypothyroidism is failure of the pituitary gland to secrete thyroid stimulating hormone (TSH). This is usually caused by a tumor in the region of the pituitary. Rarely the cause is an infiltration of the pituitary by inflammatory cells from the immune system or foreign substances (such as iron in hemochromotosis). Hypothyroidism may cause a variety of symptoms and can affect all body functions. The body's normal rate of functioning slows, causing mental and physical sluggishness. Symptoms vary from mild to severe. The most severe form is called myxedema, which is a medical emergency and can lead to coma and death. Risk factors for secondary hypothyroidism include being over 50 years old, being female, and having a history of pituitary or hypothalamic dysfunction. Symptoms:Early symptoms:
Late symptoms:
Signs and tests:A physical exam usually reveals a small thyroid gland. Vital signs (temperature, pulse, rate of breathing, blood pressure) reveal a slow heart rate, low blood pressure, and low temperature. A chest x-ray may reveal an enlarged heart. Laboratory tests to determine thyroid function include:
Additional laboratory abnormalities may include:
Treatment:The purpose of treatment is to replace the deficient thyroid hormone. Levothyroxine is the most commonly used medication. The lowest dose effective in normalizing thyroid function is used. Life-long therapy may be necessary. Medication must be continued even when symptoms subside. After replacement therapy has begun, report any symptoms of increased thyroid activity (hyperthyroidism), such as restlessness, rapid weight loss, and sweating. A high-fiber, low-calorie diet and moderate activity will help relieve constipation and promote weight loss if weight was gained during the time when thyroid activity was low. In individuals with accompanying hypoadrenalism, steroid replacement must be instituted before thyroid replacement is begun. In patients who have hypothyroidism caused by a pituitary tumor, surgery may be required. However, surgery may not cure the hypothyroidism, and thyroid replacement will still be needed. Myxedema coma is treated by intravenous (IV) thyroid replacement and steroid therapy. Supportive therapy of oxygen, assisted ventilation, fluid replacement, and intensive care nursing may be indicated. Support Groups:Expectations (prognosis): With early treatment, return to the normal state is usual. However, relapses will occur if the medication is not continued. Myxedema coma can result in death. Complications: Myxedema coma, the most severe form of hypothyroidism, is rare. It may be precipitated by an infection, illness, exposure to cold, or certain medications. Symptoms and signs of myxedema coma include:
Other complications include:
Calling your health care provider: Prevention:This condition may not be preventable. Awareness of risk may allow early diagnosis and treatment. What hormones does the thyroid gland produce?The main hormones produced by the thyroid gland are thyroxine or tetraiodothyronine (T4) and triiodothyronine (T3).
What does the thyroid gland produce and what are the functions of these secretions?The thyroid gland is an endocrine gland in your neck. It makes two hormones that are secreted into the blood: thyroxine (T4) and triiodothyronine (T3). These hormones are necessary for all the cells in your body to work normally.
Which substance does the thyroid gland need to function properly quizlet?thyroid hormone production is dependent on Iodine availably and you get Iodine from the diet.
How is T3 and T4 produced?T4 is produced solely by the thyroid gland. About 80% of T3 is formed by the removal of one iodine atom from T4, a process called deiodination. This occurs primarily in the liver and kidney, but T3 is also produced in some, if not all tissues.
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