Shirley Tai is a 43-year-old elementary school teacher. At her annual checkup, S

Question

Shirley Tai is a 43-year-old elementary school teacher. At her annual checkup, Shirley complained that, despite eating less, she had gained 16 lb. in the past year. Her physician might have attributed this weight gain to “getting older” except that Shirley also complained that she has very little energy, always feels cold (when everyone else is hot), is constipated, and has heavy menstrual flow every month. In addition, the physician noticed that Shirley’s neck was very full. Her doctor ran a thyroid profile on her

T4 3.1 g/dL (normal, 5–12 g/dL)

TSH 85 mU/L (normal, 0.3–5 mU/L)

Thyroid antimicrosomal antibodies Increased

T4, thyroxine; T3, triiodothyronine; TSH, thyroid-stimulating hormone.

A.) What disease do you think she had? Why?

B.) Why was her thyroid-stimulating hormone (TSH) level increased?

C.) Why were her antimicrosomal antibodies increased? What effect do s that have on the thyroid gland? Explain a possible mechanism.

Explanation / Answer

1. Shirley has been suffering from hypothyroidism.

2. The symptoms of hypothyroidism are feel cold, tired, 10% weight gaining due water and salts.

3. The function of thyroid gland is to take iodine, and convert it into thyroid hormones such as thyroxine (T4), and tri-iodothyronine (T3)

4. Thyroid cells absorb iodine and combine the tyrosine to make T3 and T4.

5. These T3 and T4 release in to the blood stream and are transported to body parts where they control metabolism such conversion of oxygen and calories to energy.

6. Thyroid gland is under control of Thyroid Stimulating Hormone(TSH). When the level of T3 and T4 drops too low, pituitary gland produces TSH.

7. This is the reason Shirley had 85 mU/L in her thyroid profile.

8. The symptoms of hypothyroidism are feel cold, tired, 10% weight gaining due water and salts.

9. This hypothyroidism causes "Hashimoto's Thyroiditis" which leads to inflammation of thyroid gland. This is the reason Shirley's neck was very full.

10. Hashimoto's thyroiditis is an autoimmune disorder. Her body produces antibodies that attack and destroy the thyroid gland. So her anti-microsomal antibodies increased.

11. Hypothyroidism causes constipation by slowdown of digestive processes.

12. Because of hypothyroidism she had longer menstrual periods with a heavier menstrual flow.

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