Hypothyroidism Essay

Hypothyroidism Normally, the thyroid-stimulating hormone (TSH) is produced when the hypothalamus excretes thyrotropin-releasing hormone (TRH). The secretion of TRH triggers the pituitary gland to release TSH. TSH then activates a release of triiodothyronine (T3) and thyroxine (T4), controlling the body’s metabolism. When T3 and T4 levels rise, the secretion of TRH and TSH decrease. When thyroid hormone levels decline, there is an increase in TRH and TSH secretion (Buttaro, Trybulski, Bailey, & Sandberg-Cook, 2011). Hypothyroidism is primarily diagnosed by thyroid-stimulating hormone (TSH) assays. If TSH levels are increased, it is recommended to measure free thyroxine (T4) or the free thyroxine index (FTI), which reflects the free hormone
level. Results of hypothyroidism usually present as an increased TSH with a decline in T4 or FTI. Elevated TSH with normal free T4 or FTI indicates mild hypothyroidism (Buttaro et al., 2011). Symptoms of hypothyroidism include fatigue, sleepiness, loss of energy, lethargy, weight gain, hair loss, brittle hair, diminished appetite, cold intolerance, dry skin, muscle or joint pain, weakness in the extremities, depression, emotional instability, mental impairment, absent-mindedness, memory loss, failure to concentrate, constipation, impaired fertility, and/or decreased perspiration.
C.S. currently exhibits majority of symptoms associated with hypothyroidism including a fat pad, fatigue, loss of energy, weight gain, hair loss, brittle hair, cold intolerance, dry skin, and constipation (Buttaro et al.,
2011). C.S. came in the office a week ago with complaints of hypothyroidism including fat pad on the back of her neck. As a result, thyroid function assays were drawn to rule out hypothyroidism. She was started on levothyroxine 50 mcg once every day. She returned to the office one week later without improvement of symptoms; therefore to levothyroxine was increased to 75 mcg tablet 1 once daily. Primary hypothyroidism is an endocrine disorder caused by a deficiency of thyroid hormone. Causes of thyroid hormone deficiency include a decrease in iodine intake or an autoimmune thyroid disease, Hashimoto disease (Buttaro et al., 2011).
Medication synthesis

C.S.
was prescribed Levothyroxine (Synthroid), a hormonal replacement due to dysfunction of her thyroid gland leading to insufficient levels of the thyroid hormone. Levothyroxine is an artificial form of the thyroid hormone, thyroxine (T4) that is made and released by the thyroid gland. Levothyroxine treats hypothyroidism by replacing deficient thyroid hormone. The prescribed Levothyroxine (Synthroid) dose is 75 mcg is appropriate for moderate hypothyroidism as she continues to exhibit signs while taking 50 mcg (Lexi-Comp, 2016). Serious side effects that should be discussed with the patients include tachycardia, hot flashes, insomnia, fever, changes in your menstrual periods, sweating, diarrhea, vomiting, fluctuations in weight, increased sweating, appetite changes, heat intolerance, nervousness, mood changes, or fatigue. The patient was directed to notify the provider if these symptoms arise, which may indicate the need for medication adjustment (Lexi-Comp, 2016). Drugs that should be avoided fours hours prior or following Levothyroxine (Synthroid) include antacids containing aluminum or magnesium, ferrous sulfate, cholestyramine, sucralfate, and calcium carbonate. C.S. is currently not taking any of these medications but should be considered for future treatments (Lexi-Comp,
2016). After initiation of Levothyroxine (Synthroid), TSH levels will be assessed in 6-8 weeks for an indication of incomplete rise or too high of an elevation of the thyroid hormone. Synthroid can be increased while simultaneously monitoring until a desired TSH level is achieved. Levothyroxine (Synthroid) is appropriate for this patient for treatment of hypothyroidism and until a desired level of C.S. is achieved (Lexi-Comp, 2016).