Understanding Thyroid Function, Goiter, and Its Association with Thyroid Disorders

Understanding Thyroid Function, Goiter, and Its Association with Thyroid Disorders

The thyroid is an endocrine gland located in the inferior, anterior part of the neck. Its main function is to form and secrete thyroid hormones, thyroxine (T4) and triiodothyronine (T3), and to ensure iodine homeostasis within the human body. The thyroid hormones regulate metabolism. These hormones induce their metabolism-regulating effects in all nucleated cells, and their effects are evident across all body systems.

Goiter, on the other hand, is a condition characterized by an overall enlargement of the thyroid gland. It often manifests as a visible palpable swelling at the front of the neck. Goiter may cause pressure-related manifestations such as cough, difficulty breathing and swallowing, and changes in voice, among others.

Hyperthyroidism and hypothyroidism can both present with goitre. Goitre in hyperthyroidism is often a consequence of thyroid diseases such as Graves’ disease and toxic nodular goitre. In Graves, disease, an autoimmune process in the thyroid gland causes thyroid enlargement that manifests as goitre. Goitre in hypothyroidism is due to thyroid gland stimulation by the thyroid stimulating hormone in response to decreased production of the thyroid hormone, as evident in iodine deficiency (He et al., 2022). In both instances, thyroid enlargement is apparent, and goitre is evident.

The patient in the case is presenting with hyperthyroidism. Besides the goitre presentation, the manifestations of feeling warm in an otherwise cold triage room, and fullness of energy are suggestive of elevated basal metabolic rate consistent with hyperthyroidism (Hutchings et al., 2023). Grave’s disease was suspected in this case, because it is the most common cause of hyperthyroidism. The signs that informed this suspicion are the double vision and blurred vision complaints, suggestive of Grave’s ophthalmopathy.

References

He, Q., Dong, H., Gong, M., Guo, Y., Xia, Q., Gong, J., & Lu, F. (2022). New therapeutic horizon of graves’ hyperthyroidism: Treatment regimens based on immunology and ingredients from traditional Chinese medicine. Frontiers in Pharmacology, 13. https://doi.org/10.3389/fphar.2022.862831

Hutchings, K. R., Fritzhand, S. J., Esmaeli, B., Koka, K., Zhao, J., Ahmed, S., & Debnam, J. M. (2023). Graves eye disease: Clinical and radiological diagnosis. Biomedicines, 11(2), 312. https://doi.org/10.3390/

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Scenario
Thyroid gland puzzle

A patient has checked into the ER complaining of having blurry and sometimes double vision. She’s also worried about a lump starting to develop in her throat. When you bring her into triage, you quickly note exophthalmos and the lump. When taking her history, she notes that she has always been remarkably healthy and full of energy. She even brags that she doesn’t need as much sleep. She also complains that it’s warm in your usually cold triage room.

Understanding Thyroid Function, Goiter, and Its Association with Thyroid Disorders

Instructions
Answer the following questions and save your responses in a Microsoft Word document. Provide a scholarly resource in APA format to support your answers.

What do the thyroid and its associated hormones do?
What is a goitre?
There are cases when both Hyperthyroidism and Hypothyroidism could present with a goitre. Why?
Do you believe that she is presenting with hyperthyroidism or hypothyroidism? Why?
You suspect Grave’s disease. What sign made you jump to this conclusion?