Part III Thyroid Trouble Once again Ellie sat in the exam r

Part III – Thyroid Trouble

Once again, Ellie sat in the exam room waiting on Dr. Simmons. He fl ew in the door, grabbed a stool and,

to Ellie’s relief, got right to the point. “Well, your blood work does show some problems with your thyroid.

Your TSH levels are lower than they should be, your T4 levels are a bit high and your T3 levels are very high.

Th ose results suggest that you might have Graves’ disease, which means that your thyroid is releasing too much

thyroid hormone. Since thyroid hormones are responsible for your metabolic rate, that explains why your

heart rate and blood pressure are elevated, why you’ve felt nervous and can’t sleep, and why you’ve lost weight

even though you aren’t dieting.”

Ellie’s mind whirled. “Sooooo, could this also be why I can’t concentrate when I try to study and why I can’t

seem to remember anything?” Maybe there was still some hope for her in Dr. Kern’s physiology class.

“Well, maybe,” Dr. Simmons answered. “Some studies suggest that excess thyroid hormone is correlated with

decreased attention, concentration, and working memory. In other words, your thinking might not be as

clear as it should be. However, other experts argue that it’s the anxiety and nervousness that cause patients

to feel their thinking is impaired, even though there is no actual impairment. Th e good news is that with

treatment patients report an improvement in their cognitive abilities, regardless of the underlying cause.”

Ellie felt a twinge of relief. “Oh, good! Th at will certainly help my grades. But why is my thyroid releasing

too much hormone? And you said my TSH levels were low. Isn’t TSH a thyroid hormone? If my thyroid is

too active, shouldn’t it be high instead of low?”

Ellie has just asked some very good questions. If you were Dr. Simmons, how would you answer her?

Questions

. What is causing Ellie’s thyroid to secrete too much hormone?

. Is Ellie correct in thinking that TSH is a thyroid hormone? Why is her TSH level low instead of high?

Solution

1.Ellie is suffereing from Grave’s Disease that is an autoimmune disease.TSH stimulates the thyroid gland to produce thyroxine hormones; T3 and T4.In case of Grave\'s disease, an antibody known as thyroid stimulating immunoglobulin (TSI) that has similar effects as that of thyroid stimulating hormone (TSH) stimulate the thyroid gland to produce excess T3 and T4.

2.No ,Ellie is not correct when she thinks that TSH is a thyroid hormone as TSH is a pituitary hormone that regulates the thyroid gland\'s function.When thyroid gland is overactive as in case of Grave\'s disease,it produces too much of T3 and T4 hormones.In response to this,the pituitary gland releases low amounts of TSH into the blood.This is why her TSH level is low instead of high.