Thyroid Diseases

Hyperthyroidism

• Weight loss despite increased appetite
• Heat intolerance
• Palpitations/tachycardia
• Anxiety, tremor, insomnia

Multinodular goiter/Toxic multinodular goiter

• Hyperthyroidism and multiple palpable nodules

Graves disease

• most common cause of hyperthyroidism
• Presence of thyroid-stimulating hormone receptor antibodies (anti-TSH receptor)
• hyperthyroidism, pretibial myxedema, and thyroid ophthalmopathy
  • thyroid ophthalmopathy: diplopia, proptosis, and restrictive strabismus
• Lid lag/exophthalmos

Hypothyroidism

• Fatigue and weight gain
• Cold intolerance
• Constipation
• Depression, mental slowing
• Bradycardia, dry skin, brittle hair
• Congenital - Macroglossia
  • Due to the reduced breakdown of mucopolysaccharides and subcutaneous glycosaminoglycans in the tongue, leading to their increased accumulation.

Chronic lymphocytic thyroiditis (Hashimoto's disease)

• presence of antithyroid peroxidase (Anti-TPO) and antithyroglobulin antibodies
• may display evidence of hyperthyroidism from destruction of thyroid follicular cells and the unregulated release of thyroid hormone
• Fine needle biopsy demonstrates a lymphoid infiltrate with the presence of follicles and Hürthle cells

Euthyroid sick syndrome

• evidence of thyroid dysfunction in an acutely ill patient who has no previous history of thyroid abnormalities
• Variable Presentation
  • Early: Low T3, normal TSH & T4
  • Late: Low T3, TSH & T4
  • Severe acute illness: Low total T3, normal T4/TSH

Iodine deficiency 

• Hypothyroidism