Thyroid and Parathyroid Dysfunction

Thyroid And Parathyroid Dysfunction

Thyroid Gland

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The activity of the thyroid gland is controlled by the hormone of the pituitary gland. The thyroid gland may be inactive or excessively active. Inactivity of the thyroid may result in the condition called cretinism which is associated with a deficiency of the thyroid gland in early childhood, and the condition called myxedema which comes on later in life. The person with myxedema has a typical face with puffy eyelids, and an apparent lack of interest in what is going on. The skin is dry and rough, the hair coarse, brittle and dry. Because the tongue and throat are swollen, the speech is slow and slurred.

Since the condition is lack of thyroid material, the treatment includes the giving of thyroid, and the dosage is adjusted according to the need of the patient and his response to the drug.

Cretinism

The lack of sufficient secretion from the thyroid gland during early life, as mentioned previously, results in delayed development which is called cretinism. If a child develops normally and then begins to show evidences of lack of thyroid the case is called “acquired hypothyroidism.” The condition may appear as a failure of the thyroid gland to grow or as a result of failure of the pituitary gland to stimulate the thyroid by sending the pituitary secretion necessary for this purpose. The latter failure is rare.

No one sign is typical of cretinism or insufficient thyroid, but a combination is well-nigh unmistakable. The child has physical and mental torpor. The circulation of the blood is poor. In fact, all the activities of the body are under par, including the muscle tone, sweating, and the activity of the bowel. The growth, including bones and teeth, hair and brain, is stunted. The skin is thickened and coarse and fluid accumulates under the skin. The cretin is sluggish and shows little interest in what goes on around him.

The child with deficient action of the thyroid responds rapidly to treatment with thyroid extract. Almost immediately there is improvement in color and warmth of the skin. Within a few weeks there is loss of weight as the body gets rid of the extra fluid. Almost immediately, growth begins again. Because of this prompt benefit there may be a tendency to give more and more thyroid, and this will have bad results as shown in heightened excitability, nervousness and a rise in the blood pressure.

The earlier a diagnosis can be made and the sooner treatment can be begun the better. Sometimes the damage to the brain by just a few months deficiency may be so severe that it is difficult if not impossible to overcome. Such children may become irritable and unmanageable after treatment, and the doctor must determine the amount of thyroid necessary to keep the child under control.

Excess Action Of The Thyroid

Although the condition called hyperthyroidism, which is due to excessive action of the thyroid gland, was first observed around 1830, a really complete understanding of the condition did not develop until 1890. Excessive action of the thyroid may occur at any age. The condition is much more frequent in women than in men. In areas in which goiter is infrequent, women may have excessive action of the thyroid gland in a proportion of four women to one man.

The exact cause of excessive action of the thyroid gland is not known, but the most frequently accepted view at this time is that the body responds to stress, either emotional, physical, or infectious, by excessive action of the pituitary gland which in turn over stimulates the thyroid gland. If this condition goes on, such symptoms may develop as bulging of the eyes, which is a part of exophthalmic goiter; and there may be enlargement of the thyroid gland, although there are cases in which the thyroid gland is enlarged without other symptoms. The person who is over stimulated by thyroid is nervous, irritable and emotionally unstable.

Since excessive action of the thyroid is due to secretion of too much hormone or glandular substance, treatment of the condition includes a number of different procedures. The certain method is removal of a portion of the thyroid gland by surgery, with or without the use of such drugs as propylthiouracil which diminish thyroid activity.

Radioiodine, which is a radioactive form of this substance, is now used to treat excessive action of the thyroid gland. In some cases excessive action of the thyroid may be so great that serious symptoms develop, including fever, an exceedingly rapid beating of the heart and

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