Thyroid Mini-Med - The Thyroid The McMaster Mini-Med School...

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The Thyroid The Thyroid McMaster Mini-Med School March 24, 2005 Dr. William Harper Assistant Professor of Medicine, McMaster University. Endocrinologist, Hamilton General Hospital www.drharper.ca
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t 1/2 = 5-7d t 1/2 = < 24 hrs
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T4 T3 85% (peripheral conversion) 15% Protein binding + 0.03% free T4 Protein binding + 0.3% free T3 (10-20x less than T4) Normal Daily Thyroid Secretion Rate: T4 = 100 ug/day T3 = 6 ug/day ( ratio T4:T3 = 14:1 )
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T4 T3 Potency 1 10 Protein Bound 10-20 1 Half-Life 5-7d < 24h Secreted by thyroid 100 ug/d 6 ug/d
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Thyroid Function: blood tests Thyroid Function: blood tests TSH 0.4 –5.0 mU/L Free T4 (thyroxine) 9.1 – 23.8 pM Free T3 (triiodothyronine) 2.23-5.3 pM
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Thyroid Disease Thyroid Disease Hypothyroidism Hyperthyroidism Thyroid Nodules & Cancer
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Hypothyroidism Hypothyroidism Decreased thyroid hormone levels Low T4 Possibly Low T3 too. Raised TSH (unless pituitary problem!)
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Hashimoto’s Disease Hashimoto’s Disease Most common cause of hypothyroidism in North America (iodinated salt) Autoimmune lymphocytic thyroiditis Antithyroid antibodies: Thyroglobulin Ab Microsomal Ab TSH-R Ab (block) Females > Males Runs in Families!
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Subacute (de Quervain’s) Thyroiditis Subacute (de Quervain’s) Thyroiditis Preceding viral infection Infiltration of the gland with granulomas Painful goitre Hyperthyroid phase Hypothyroid phase
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