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Thyroid glands are located in the neck, in close approximation to the first part of the trachea. In humans, the thyroid gland has a "butterfly" shape, with two lateral lobes that are connected by a narrow section called the isthmus.
The microscopic structure of the thyroid is quite distinctive. Thyroid epithelial cells - the cells responsible for synthesis of thyroid hormones - are arranged in spheres called thyroid follicles .Follicles are filled with colloid ,a proteinaceous depot of thyroid hormone precursor. In the low (left) and high-magnification (right) images of a cat thyroid below, follicles are cut in cross section at different levels, appearing as roughly circular forms of varying size. In standard histologic preparations such as these, colloid stains pink .
Synthesis, continued Synthesis of thyroid hormones is conducted by the enzyme thyroid peroxidase ,an integral membrane protein present in the apical (colloidfacing) plasma membrane of thyroid epithelial cells. Thyroid peroxidase catalyzes two sequential reactions :
Iodination of tyrosines on thyroglobulin (also known as "organification of iodide ). Synthesis of thyroxine or triiodothyronine from two iodotyrosines .
Synthesis, continued
Through the action of thyroid peroxidase, thyroid hormones accumulate in colloid, on the surface of thyroid epithelial cells. Remember that hormone is still tied up in molecules of thyroglobulin - the task remaining is to liberate it from the scaffold and secrete free hormone into blood .
Feedback mechanism
Neurons in the hypothalamus secrete thyroid releasing hormone (TRH), which stimulates cells in the anterior pituitary to secrete thyroid-stimulating hormone (TSH) TSH binds to receptors on epithelial cells in the thyroid gland, stimulating synthesis and secretion of thyroid hormones, which affect probably all cells in the body . When blood concentrations of thyroid hormones increase above a certain threshold, TRH-secreting neurons in the hypothalamus are inhibited and stop secreting TRH . This is an example of "negative feedback ."
Each of the processes described above appears to be stimulated by thyroid-stimulating hormone from the anterior pituitary gland. Binding of TSH to its receptors on thyroid epithelial cells stimulates synthesis of the iodine transporter, thyroid peroxidase and thyroglobulin . The magnitude of the TSH signal also sets the rate of endocytosis of colloid - high concentrations of TSH lead to faster rates of endocytosis, and hence, thyroid hormone release into the circulation. Conversely, when TSH levels are low, rates of thyroid hormone synthesis and release diminish .
Physiologic Effects of Thyroid Hormones It is likely that all cells in the body are targets for thyroid hormones. Thyroid hormones have profound effects on many physiologic processes, such as development, growth and metabolism. Many of the effects of thyroid hormone have been delineated by study of deficiency and excess states.
Metabolism
Thyroid hormones stimulate diverse metabolic activities in most tissues, leading:
increase in basal metabolic rate. body heat production, which seems to result, at least in part, from increased oxygen consumption and rates of ATP hydrolysis.
Carbohydrate metabolism :Thyroid hormones stimulate almost all aspects of carbohydrate metabolism, including enhancement of :
insulin-dependent entry of glucose into cells increased gluconeogenesis and glycogenolysis to generate free glucose .
Thyroid Hormones and Fetal Brain Development In 1888 the Clinical Society of London issued a report underlining the importance of normal thyroid function on development of the brain. Since that time, numerous studies with rats, sheep and humans have reinforced this concept, usually by study of the effects of fetal and/or maternal thyroid deficiency. Thyroid hormones appear to have their most profound effects on the terminal stages of brain differentiation, including synaptogenesis, growth of dendrites and axons, myelination and neuronal migration .
Other Effects
Cardiovascular system :Thyroid hormones increases heart rate, cardiac contractility and cardiac output. They also promote vasodilatation, which leads to enhanced blood flow to many organs . Central nervous system :Both decreased and increased concentrations of thyroid hormones lead to alterations in mental state. Too little thyroid hormone, and the individual tends to feel mentally sluggish, while too much induces anxiety and nervousness .. Essential for development of synapses and myelination of nerves. Reproductive system :Normal reproductive behavior and physiology is dependent on having essentially normal levels of thyroid hormone. Hypothyroidism in particular is commonly associated with infertility .
Symptoms
Critinism:
Mental retardation In- proportionate musclo-skeletal growth, e.g. protruded tongue, short limbs compared to the trunk, dry skin, Constipation. Husky voice Intolerance to cold. Reproductive failure
Adult:
lethargy, fatigue, cold-intolerance, weakness, hair loss, infertility. Weight gain, sleepy, If these signs are severe, the clinical condition is called myxedema
Hyperthyroidism
Causes: results from secretion of thyroid hormones due to:
In humans the most common form of hyperthyroidism is Graves disease ,an immune disease in which autoantibodies bind to and activate the thyroid-stimulating hormone receptor, leading to continual stimulation of thyroid hormone synthesis. Another interesting, but rare cause of hyperthyroidism is so-called hamburger thyrotoxicosis Secretory tumor of thyroid or pituitary gland.
Manifestations:
Common signs include nervousness, insomnia, high heart rate, eye disease and anxiety. Graves disease is commonly treated with anti-thyroid drugs (e.g. propylthiourea, methimazole), which suppress synthesis of thyroid hormones primarily by interfering with iodination of thyroglobulin by thyroid peroxidase.
Goiter
Definition:
Enlargement of thyroid gland
Causes:
Iodine deficiency:
Epidemics :as in oasis Repeated pregnancy.
Hyperthyroidism
Symptoms of hyperthyroidism (overactive thyroid) include: fatigue or tiredness weight loss hair loss bulging eyes soft nails nervousness and irritability rapid or irregular heartbeat (i.e., arrhythmia ( increased perspiration feeling hot when others are not, or trouble withstanding the heat irregular or scant menstrual periods trouble getting pregnant or infertility more frequent bowel movements or diarrhea troubled or disturbed sleep weakness in muscles (e.g., can't easily walk up stairs or lift heavy objects ( tremors or trembling hands eye irritation or problems seeing an enlarged thyroid (i.e., goiter), which may appear as a swelling at the base of the neck (American College of Obstetricians and Gynecologists, 1999; American Foundation of Thyroid Patients, 1994; Mayo Clinic, 2002b; National Women's Health Information Center, 2002; The Hormone Foundation, 2002a.(
Graves' disease
The most common form of hyperthyroidism is a condition known as Grave's disease. Graves' disease is a type of autoimmune disease) see box on autoimmune disease ( in which the immune system over stimulates the thyroid gland (National Women's Health Information Center, 2000b.( Person's with Grave's disease may experience: anxiety irritability difficulty sleeping rapid, forceful, or irregular heartbeat fine tremor of the hands or fingers increase in perspiration sensitivity to heat weight loss, despite normal diet enlargement of the thyroid gland (i.e., goiter ( light menstrual periods frequent bowel movements .
Particularly related to Graves' disease are eye symptoms, known as Graves' opthalmopathy. In Graves' opthalmopathy, the eye protrudes beyond its protective orbit because tissues and muscles behind the eye swell. This condition can result in: drying of the front of the eye excess tearing sensation of sand or grit in the eye(s ( reddened or inflamed eyes widening of the space between the eyelids swelling of the lids and tissue around the eyes bulging eyes decreased blinking and excessive staring light sensitivity blurry or double vision limited eye movement .
Treatments for Graves' disease include: Medications -- anti-thyroid drugs, which inhibit production or conversion of the active thyroid hormone Radioactive iodine -- iodine damages thyroid cells to shrink the thyroid gland, thus reducing hormone levels Surgery -- a subtotal thyroidectomy, in which a surgeon removes most of the thyroid gland and renders it incapable of overproducing thyroid hormone (National Graves' Disease Foundation, 2000; National Women's Health Information Center, 2000b .(
What is Goiter?
A goiter is an abnormal enlargement of the thyroid gland and can occur for a number of different reasons. The thyroid is a small, butterfly- shaped gland inside the neck, just below your Adams apple. The thyroid gland produces hormones which control the bodys metabolism and regulate the rate at which the body carries out its functions . The presence of goiter usually means that the thyroid gland is not functioning normally .It can occur in a gland that is overactive, producing too much hormone (hyperthyroidism), or that is underactive, producing too little hormone (hypothyroidism .( Goiter puts pressure on other parts of the neck such as the trachea and esophagus - making it difficult to breathe and swallow .Often, goiters are also removed for cosmetic reasons. They are more common in women and the elderly.