Your dermatologist may be the first doctor to suspect hyperthyroidism or hypothyroidism because many signs of thyroid disease affect the skin, hair, and nails. Abnormal functioning of the thyroid causes numerous health problems. It regulates all aspects of your metabolism, from hair growth and nutrient absorption to body temperature and heart rate. While small in size, the thyroid gland has enormous impact on your health and well-being. 2014 Sep 15 90(6):389-96.The thyroid is a small, butterfly-shaped gland located at the base of the neck.
The initial thyrotoxic phase is associated with thyroid pain, high serum thyroid hormone levels with a low radioiodine uptake, elevated erythrocyte sedimentation rate, elevated C-reactive protein, and a systemic illness similar to influenza, with fever, myalgia, and malaise. Clinical features and outcome of subacute thyroiditis in an incidence cohort: Olmsted county, Minnesota, study. Fatourechi V, Aniszewski JP, Fatourechi GZ, et al. Clinical characteristics of 852 patients with subacute thyroiditis before treatment. Inflammation of the thyroid characterized by a triphasic course of transient thyrotoxicosis, followed by hypothyroidism, followed by return to euthyroidism. Gain of function TSH receptor mutations and iodine deficiency: implications in iodine prophylaxis. Tonacchera M, Vitti P, De Servi M, et al. Worldwide, iodine deficiency is the most common cause of nodular goiter. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Haugen BR, Alexander EK, Bible KC, et al.
However, nonfunctioning thyroid nodules in the same goiter may be malignant. Nodules function independently of TSH and are almost always benign. 2016 Oct 20 375(16):1552-1565.Ī toxic multinodular goiter (MNG also known as Plummer disease) contains multiple autonomously functioning nodules, resulting in hyperthyroidism. Diagnosis is mostly clinical and is usually confirmed by laboratory evidence of thyroid dysfunction, most commonly hyperthyroidism. 2016 26:1343-1421.Įxtrathyroidal manifestations include orbitopathy, pretibial myxoedema (thyroid dermopathy), or acropachy, which do not occur with other causes of hyperthyroidism. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Hyperthyroidism is caused by TSH receptor antibodies (TRAb). Graves disease is an autoimmune thyroid disease and is the most common form of hyperthyroidism in countries with sufficient iodine intake. Further testing (e.g, radioactive iodine uptake) may be used subsequently to clarify etiologies in some cases.
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Free T4 assay is the test of choice to evaluate an abnormal TSH level. Suppressed or elevated TSH confirms presence of thyroid dysfunction but not its cause.
Initial evaluation of thyroid dysfunction - Are simultaneous TSH and fT4 tests necessary? PLoS One. Investigation and Management of Primary Thyroid Dysfunction. American Thyroid Association guidelines for detection of thyroid dysfunction. A serum TSH assay is the test of choice to screen for thyroid function disorders in the absence of hypothalamic or a pituitary pathology. Thyroid function tests (TFTs) are the most commonly used endocrine test.
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