Nutrition and Metabolism Dysfunction: Thyroid and Adrenal Disorders

1
Nutrition and Metabolism Dysfunction Thyroid and
Adrenal Disorders

• Bringing it all together!

2
Hyperthyroidism

• The signs and symptoms are mainly a result of
  what two things?
• Hyper-metabolism
• Overly sensitive sympathetic nervous system

3
TSH LEVELS
The body senses that there is too much thyroid
hormone and via the negative feedback loop,
inhibits secretion of TSH.
4
Thyroid/Adrenals

• What would be the implications for removal of the
  pituitary gland?
• The hypothalamus and anterior pituitary are
  integral to the hormone cascade and negative
  feedback process!
• Would need replacement of both steroids and
  thyroid hormone

5
Thyroid Hormone Replacement

• Why was Mr. Bill Loney on the same home going
  medications that Kathy Twohy takes?
• Bill was put into a hypothryoid state via removal
  of his thyroid gland. Kathy was put into a
  hypothyroid state by autoimmune destruction of
  her thyroid gland and therefore both needed
  replacement.

6
Hypothyroidism

• Give a description of a patient who has obvious
  hypothyroidism (clothes, hair, face, gender,
  speech patterns)
• Jacket, thin hair, thick tongue and facial edema,
  slow/slurred speech, female, lethargic and
  forgetful

7
Thyroid Storm

• What is the most dangerous aspect of thyroid
  storm?
• Massive sympathetic outflow and the cardiac
  implications of it

8
Addisonian Crisis

• What are three things a patient with
  Adrenocortical insufficiency should never leave
  home without?

1. Med alert bracelet 2. IM Cortisone
(syringe/medication) 3. Card with a list of
current meds/dosages and what to do in case of an
emergency
9
Other questions

• What do we call the cluster of signs and symptoms
  that we expect to see for a patient on high doses
  of Prednisone or other corticosteroids?
• Cushings Syndrome

10
Questions

• What questions/clarifications do you have or need
  from the modules?

11
Parathyroid gland
12
Purpose Maintain calcium and phosphorus balance

• Parathyroid hormone maintains an adequate amount
  of calcium in the blood
• Major cause of hyperparathyroidism benign
  parathyroid tumor

13
Hyper-parathyroidism

• Will have increased levels of calcium in the
  serum
• Loss of calcium from bones
• Bone fractures
• Altered cardiac electrical conduction
• Changes in personality, fatigue
• Increased blood clotting
• Risk for kidney stones
• Decreased reflexes
• GI concerns ?peristalsis
• Increased gastrin hormone secretion

14
Treatment

• Parathyroidectomy is the most common treatment
• May be hypocalcemic immediately after surgery
• May need life time calcium and vitamin D
  replacement