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The thyroid system of the thyroid hormones T 3 and T 4 [1] Thyroid hormones are any hormones produced and released by the thyroid gland, namely triiodothyronine (T 3) and thyroxine (T 4). They are tyrosine-based hormones that are primarily responsible for regulation of metabolism. T 3 and T 4 are partially composed of iodine, derived from food. [2]
The hypothalamic–pituitary–thyroid axis ( HPT axis for short, a.k.a. thyroid homeostasis or thyrotropic feedback control) is part of the neuroendocrine system responsible for the regulation of metabolism and also responds to stress. As its name suggests, it depends upon the hypothalamus, the pituitary gland, and the thyroid gland .
Euthyroid sick syndrome ( ESS) is a state of adaptation or dysregulation of thyrotropic feedback control [ 1] wherein the levels of T3 and/or T4 are abnormal, but the thyroid gland does not appear to be dysfunctional. This condition may result from allostatic responses of hypothalamus-pituitary-thyroid feedback control, dyshomeostatic disorders ...
Myxedema coma is an extreme or decompensated form of hypothyroidism and while uncommon, is potentially lethal. [ 1][ 2][ 3] A person may have laboratory values identical to a "normal" hypothyroid state, but a stressful event (such as an infection, myocardial infarction, or stroke) precipitates the myxedema coma state, usually in the elderly.
Thyroid storm is characterized by an acute onset of symptoms of hyperthyroidism ( fast heart rate, restlessness, agitation) accompanied by other features such as fever (temperatures often above 40 °C/104 °F), hypertension, mental status changes, diarrhea, and vomiting. [ 11]
Levothyroxine. Levothyroxine, also known as L-thyroxine, is a synthetic form of the thyroid hormone thyroxine (T 4 ). [ 5][ 8] It is used to treat thyroid hormone deficiency (hypothyroidism), including a severe form known as myxedema coma. [ 5] It may also be used to treat and prevent certain types of thyroid tumors. [ 5]
Propylthiouracil. Propylthiouracil ( PTU) is a medication used to treat hyperthyroidism. [ 3] This includes hyperthyroidism due to Graves' disease and toxic multinodular goiter. [ 3] In a thyrotoxic crisis it is generally more effective than methimazole. [ 3]
In the early 1960s, desiccated thyroid hormones (thyroid extract) began to be replaced by levothyroxine (synthetic T4), or by combinations of T4 and T3. Replacement occurred faster in the United Kingdom than in North America, but by the 1980s more patients were being prescribed synthetic T4 (levothyroxine) or synthetic T4/T3 combinations than ...