Signs and symptoms of hyperthyroidism and hypothyroidism

Increase or decrease secretion of thyroid hormone gives a huge impact on the overall body functions. Here we see about the signs and symptoms of hypothyroidism and hyperthyroidism, which may help to act as an alarm sign to check your thyroid on time.

Signs and symptoms of hypothyroidism ( decreased thyroid secretion ):

  • Tiredness and weakness, people will have dull and lazy feel and it is quite easy form them to sleep even for 12-14 hours a day.
  • Dry and course skin, often feel cold, very much sensitive to cold temperature with cool peripheral extremities
  • Puffy face, hands and feet called myxedema and peripheral edema
  • Increased hair loss and diffuse alopecia ( generalissd loss of hair all over the body)
  • Difficult in concentrating and poor memory
  • Constipation
  • Weight gain with poor appetite
  • Difficulty in breathing (dyspnea)
  • Decreased heart rate and rhythm ( bradycardia )
  • Hoarseness of voice
  • Delayed tendon reflex relaxation ( delay in the relaxation of muscle after contraction, seen well on the calf muscles )
  • Intially menorrhagia ( heavy menstural bleed ) later it goes into oligomenorrhagia ( less menstrual bleed ) or amenorrhagia ( no mensturation )
  • Parasthesia ( tingling or prickling sensation, which occurs now and then, often on the skins of hand and foot )
  • Hearing impairment
  • Carpel tunnel syndrome Reference – Orthoinfo

Signs and symptoms of hyperthyroidism ( increased thyroid secretion) :

  • Hyperactive, irritability and dysphoria, they always will be in the state of dissatisfaction and uneasiness
  • Heat intolerance and profuse sweating
  • Warm and moist skins
  • Weight loss with increased appetite
  • Palpitations and tachycardia (increased heart rate and rhythm)
  • Goiter( abnormal enlargement of the thyroid gland )
  • Diarrhea
  • increased urination
  • tiredness and weakness
  • muscle weakness and peripheral degeneration of muscles
  • Upper eyelid gets retracted causing the eyeball to protrude out called exophthalmia.
  • Oligomenorrhagia and loss of libido
  • Gynecomastia

Not all the symptoms are subjective but when you come across 4-5 at a time, it is better to consult your physician.

Reference:

Harrison’s principle of internal medicine, 19th edition.

Thyroid hormone – Synthesis and functions

Often you will tend to hear about thyroid hormone very much correlated with the body function. Whenever you get deviated from the regular activities, the foremost questions arise will be like check your thyroid, what js your T3 and T4 levels ?? Rite !!!! So why these hormone have special concern? What are their functions and how their imbalance will impact our body ? Let’s have a look…

Secretions of thyroid hormone :

Thyroid hormone secretes,

Synthesis of thyroid hormone is controlled by thyroid stimulating hormone (TSH) from anterior pituitary gland and iodine is the key element required for the synthesis of T3 and T4.

Functions of T3 and T4 :

Functions of thyroid hormone on specific bodily mechanisms:

  • Stimulate carbohydrate metabolism
  • stimulate fat metabolism
  • Increased requirement of vitamins
  • maintain basal metabolic rate (BMR)

All these factors will help to maintain tan the body weight under control.

Functions of thyroid hormone on heart and blood vessels:

  • Increased blood flow and cardiac output
  • Maintain the heart rate
  • strengthen the heart
  • Maintain the blood pressure mainly on the arteries.

Functions on respiration :

Increase the rate and depth of respiration thereby increasing the oxygen consumption of the body

Functions on gastrointestinal tract:

  • Increase appetite and food intake
  • increase digestive juice secretion
  • Increase intestinal motility and provide effective digestive process

Functions on muscles and nervous system :

In general thyroid hormone increase the rapidity of cerebral function and also helpful for maintaining the proper sleep cycle. Thyroid hormone plays an essential role for body builders.

Functions on other hormones :

For normal sexual functions, thyroid hormone needs to be approximately normal. Thyroid hormone indirectly regulate the function of other hormones like insulin, glucagon, growth hormone and corticosteroids.

Functions of calcitonin :

  • Increase the bone density by increasing the calcium deposits on the bone
  • Decrease the blood calcium level
  • Decrease the osteoclastic (bone destructive cell) activity

* The role of thyroid hormone on the calcium regulation is of significantly less importance as compared to the parathyroid hormone.

Any imbalance in the secretion of thyroid hormone will cause either hyperthyroidism (increased secretion ) or hypothyroidism ( decreased secretion) which will have their own consequences attributed to the above functions.Signs and symptoms of hyperthyroidism and hypothyroidism

 

References :

Textbook of medical physiology by Arthur C.Guyton

Ganong’s review of medical physiology

 

Role of calcium in the body

Calcium is the fifth abundant element in the body which plays a vital role in skeletal structural units. The total calcium in the body is 100-170 gms, in which 99% present in the bones. The normal serum calcium levels are between 9-11 mg/dl. Values that are lower/higher than this will have its own consequences.

Factors that control the calcium homeostasis are parathyroid hormone, calcitonin by thyroid hormone, vitamin D and dietary intake of calcium and phosphate.

 Roles of calcium in the body  :

A large role in the formation of bones and teeth and maintance of skeletal structures :

The organic matrix of the bones and teeth are composed of calcium and phosphate in the larger amount. Hormonal imbalance like hypo/hyper secretion of thyroid,  parathyroid, corticosteroids, and sunlight exposure will have a major effects on bone density and skeletal structures.

For membrane permeability :

Apart from sodium and potassium, ionised form of calcium in the extracellular fluid also have a role in membrane permeability, thus helps in balancing the inner and outer fluid content of the cells.

For normal heart rhythm :

Calcium ions are essential for the contraction of heart muscles thus help in maintaining the proper rhythmicity of the heart beat. Low blood calcium levels will increase the risk of ventricular tachycardia ( too rapid contraction of the lower chamber of the heart).

For neuromuscular excitability and muscle contraction :

Calcium ions are required for the electrical signalling process to generate impulse for neuromuscular excitability and muscle contraction. Low serum calcium level can cause hyper irritability and tetany ( muscle spasm) with characteristic carpopedal spasm, while the high concentration can cause depressed nerve conductivity and muscle rigor.

For coagulation of blood :

Calcium is one of the factor in the blood coagulation (blood clotting) cascade. Low blood calcium level will cause reduction in blood clotting ability and increased internal hemorrhage.

As secondary and tertiary messenger in hormone action :

Calcium acts as a messenger for the hormones to act on their target organs and to elicit desirable function. Low level of calcium will impair the adequate target – action ability.

References :

Textbook of physiology by Guyton

Review of internal medicine by Harrisons

Textbook of oral pathology by Shafers.

 

 

Dry socket – Reason and treatment

After removal of tooth, blood clot formation is an essential element for the healing to take place. When the blood clot is dislodged from the socket, healing becomes extremely slow or nil and the condition is called as dry socket.

Reasons for dry socket :

  • Dislodgement of blood clot from the socket
  • Difficulty in tooth removal due to its anatomical hinderance
  • Person underwent radiotherapy recently
  • Use of oral contraceptives

signs and symptoms of dry socket :

  • It usually occur couple of days after tooth removal, sometimes may appear after five to ten days as well.
  • The tooth removed region becomes very painful with necrotic bone, foul smelling and without pus formation.
  • The pain may get radiate to neck and ear region
  • Some patients may encounter mild fever and lymph node enlargement

Treatment and instructions :

  • Do warm saline gargle and immediately report to the dental surgeon
  • Complete debridement with ample of irrigation and ZOE + iodoform dressing will be given
  • The dressing should be changed every day
  • Usually the pain will be subsided in a day or two after debridement and dressing process.

 

Reference:

Textbook of oral pathology by shafers

 

Dry mouth – cause and effect

Less amount of saliva secretion cause dry mouth. It is a clinical manifestation of salivary gland dysfunction. There are various factors that causes dry mouth.

Various causes for dry mouth : 

Radiation induced 

Radiation therapy to head and neck region for cancer treatment affects the salivary gland cells (dose dependent) causing dry mouth.

Medicine/ drug induced

Certain drugs that are taken for vomiting, allergy, blood pressure, muscle spasm and convulsions can cause decreased salivary flow because of reduced activity of para-sympathetic action.

Local factors

Like smoking, mouth breathing and decreased chewing can lead to dry mouth

Developmental abnormality

When abnormality of salivary gland occurred during the formation of fetus, or tumor or autoimmune states can cause dry mouth

Systemic alternations

Nutritional deficiency like anemia, vitamin A deficiency and hormonal imbalance can cause dry mouth.

Fluid loss associated with hemorrage, sweating, diarrhea, vomiting and dehydration, Diseases like diabetes, certain syndromes and graft versus host resistances can  cause dry mouth.

Signs and symptoms of dry mouth:

Increased thirst, increased uptake of fluids, frequent use of means like chewing gums and sour candy, difficulties in swallowing, speech and eating dry foods.

Burning and tingling sensation in the mouth, frequent oral infection, intolerance to dental appliance, abnormal taste in mouth, tongue may adhere to soft palate, painful salivary gland enlargement, increased incidence of dental caries. Saliva consistency becomes thick, foamy and ropey.

Suggestions to the people have dry mouth :

Try sweet and tart food and beverages like lemonade, they may help to produce more saliva

chewing of sugar free candy and ice cubes

Use soft and liquid foods, which may be easier to swallow

Hydrate well and drink frequently

Avoid chewing vitamin c and acidic lozenges, dry, sticky and salty foods.

Report to your physician for taking proper medical management.

 

References

Textbook of oral medicine by Anil Govindrao Ghom, 2nd edition