Hypothyroidism by PRAVIN. G

1. HYPOTHYROIDISM
- BY PRAVIN. G

2. OUTLINES :
• Introduction
• Etiology
• Sign and symptoms
• Diagnosis
• Pathophysiology
• Management and treatment

3. INTRODUCTION :
Hypothyroidism is a condition in which the thyroid gland is not able to produce enough thyroid
hormone. Since the main purpose of thyroid hormone is to run your body’s metabolism, it is not
surprising that people with hypothyroidism often have symptoms associated with a slow metabolism.
The thyroid gland is located in the front lower part of your neck. Hormones released by the
gland travel through your bloodstream and affect nearly every part of your body, from your heart and
brain, to your muscles and skin. The thyroid controls how your body’s cells use energy from food, a
process called metabolism. Among other things, your metabolism affects your body’s temperature, your
heartbeat, and how well you burn calories. If you don’t have enough thyroid hormone, your body
processes slow down. That means your body makes less energy, and your metabolism becomes sluggish.

4. HYPOTHYROIDISM :

5. ETIOLOGY :
• Hashimoto’s disease, an autoimmune disorder where your immune system attacks your thyroid.
This is the most common cause.
• Congenital hypothyroidism, hypothyroidism that is present at birth
• Surgical removal of part or all of the thyroid
• Radiation treatment of the thyroid
• Certain medicines
• Thyroiditis, inflammation of the thyroid
• In rare cases, a pituitary disease or too much or too little iodine in your diet

6. SIGN AND SYMPTOMS :
• Fatigue
• Weight gain
• Joint’s and muscles pain
• Constipation
• Dry skin
• Decrease sweating
• Depression
• Slowed heart rate

7. DIAGNOSIS :
• A rise in the TSH level is the first evidence of primary hypothyroidism.
• Many patients have a free T4 level within the normal Range (compensated hypothyroidism) and
few, if any,
• As the disease progresses, the free T4 concentration drops below the normal level. The T3
concentration is often maintained in the normal range despite a low T4.

8. Hypothyroidism is a hypo metabolic state that results from deficiency in T3 and T4.
Work and synthesis of thyroid hormone :
PATHOPHYSIOLOGY :
Hypothalamus with the help of T.R.H.
↓
Pituitary glands with the help of T.S.H.
↓
Thyroid glands
↓
Plasma iodine

9. CONTINUED.....
↓
I peroxidase enzyme
↓
I2 iodination of thyroxine gland to form MIT and DIT
↓
Formation of T4, T3
↓
Storage in thyroid gland

10. CONTINUED.....
↓
Release of T4, T3 in blood
↓
Combine with nuclear receptor
↓
Activate different genes
↓
Synthesis of different genes
↓
Show effect

11. CONTINUED.....
• T.R.H.- thyroid releasing hormone
• T.S.H.- thyroid stimulating hormone
• M.I.T.- mono polo tyrosine
• D.I.T.- Di iodo tyrosine
Due to deficiency of T3 and T4 hormone or iodine hypothyroidism can be
possible.

12. MANAGEMENT AND TREATMENT :
• Non Pharmacological treatment :
a. Fish
b. Egg
c. Chicken
d. Diary products
e. Mushrooms
F. Yoga and physical activities

13. CONTINUED...
• Pharmacological treatment :
* Drugs for hypothyroidism :
1. Levothyroxine (T4): it is drug of choice thyroid hormone replacement therapy in
hypothyroidism patients. Treated with 1.5 to 1.8 micrograms per kg initially but in
cardiac patients dose increased to 12.5 to 25.0 micrograms per kg and It having
long Half life 7 day’s .
2. Tri- iodothyronine(T3): it having Short half life 1day.
3. T3 and T4 are given orally.

14. CONTINUED....
Treatment chart :

15. REFERENCE :
1. https://www.lalpathlabs.com/blog/understanding-hypothyroidism/
2. https://www.medicoverhospitals.in/diseases/hypothyroidism/
3. https://www.medicalnewstoday.com/articles/163729

16. THANK YOU!