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Thyroid & Thyroid Diseases

Submitted By Submitted to
Anushka Sharma Ms. Lakshmi Peter
XI D Biology Teacher
This is to certify that Anushka Sharma, a student of class
XI D has successfully completed the research on the
below mentioned project under the guidance of Ms.
Lakshmi Peter during the academic year 2016-17.

Signature of Signature of
Biology Teacher Principal

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Acknowledgeme
nt

P
rimarily I would like to thank God for being able to complete
this project with success. Then I would like to express a deep
sense of thanks & gratitude to our principal Dr. Jaishree
Kanwar, for her co-ordination in extending every possible
support for the completion of this project. This project would not been
feasible without the proper guidance of biology teachers Ms. Lakshmi
Peter & Dr. Shelly Chaturvedi who guided me throughout this project
in every possible way. Her suggestions and her instructions has served
as the major contributor towards the completion of the project.

I also thank my parents for their motivation & support. I must thank my
classmates for their timely help & support for compilation of this
project.

Last but not the least, I would like to thank all those who had helped
directly or indirectly towards completion of this project.

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Anushka Sharma
Class-XI D

Contents
1. Thyroid Gland 5
2. Hormones of Thyroid Gland.. 6
3. Thyroid Disorders..
3.1 Hyperthyroidism 8
3.2 Hypothyroidism.. 12
4. History 17
5. Other Animals 18
6. Case Study...... 19
7. Bibliography... 20

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The Thyroid Gland

T
he thyroid gland is the largest endocrine gland located anterior
to the thyroid cartilage of the larynx in the neck. It is
composed of two lobes which are located on the either sides
of the trachea. Both the lobes are interconnected with a thin
flap of connective tissues called isthmus.

The thyroid gland is composed of microscopic spherical sacs, the


follicles held together by loose connective tissue, the stromal tissue.
Beside containing blood capillaries, the stromal tissues contains small
cluster of specialized parafollicullar cells or C cells. Each thyroid
follicle is composed of follicular cells, enclosing a cavity. The follicles
are filled with a homogenous substance called colloid, composed of
glycoprotein, thyroglobulin. The thyroid gland can store enough
hormones in the colloid to supply the body for about two months.

The thyroid as it may be seen from


The human thyroid as viewed from
a posterior view, from behind the
the front, with arteries visible.
trachea.

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Hormones of Thyroid Gland
The thyroid gland secrets three hormones:
Thyroxine or tetra-iodothyroxine (T4), triiodothyroxine (T3) and
thyrocalcitonin (TCT).

Thyroxine (T4) and triiodothyroxine


(T3) are secreted by the thyroid
follicular cells, while
thyrocalcitonin is secreted by the C-
cells of the thyroid gland. The
hormone thyroid stimulating
hormone (thyrotropin) released
Section of thyroid under microscope from anterior pituitary, simulates the
1.Follicles; 2.Follicular cells; 3.Endothelial thyroid gland to secrete its
cells hormones.

Thyroxine (T4) and Triiodothyroxine


(T3) are usually considered together under
the name thyroid hormone (TH) because
they have similar effect on the target cells.
T4 and T3 contain four and three atoms of
iodine respectively; therefore, they are
named so. They are synthesized by
attaching iodine to the amino acid tyrosine
by enzymatic action. T3 is secreted in
smaller amounts but is more active than
T4. However T4 is converted to T3 by the
removal of one iodine in liver, kidney and
some other tissues. The thyroid gland is
the only
endocrine gland that stores its hormones in large quantity. The hormone
is stored in the colloid that fills the follicles and is released into the

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blood when required. The T4 and T3 perform the following functions:
a) They regulate the metabolic rate
of the body thus, maintains
basal metabolic rate (BMR).
The structural formula and the
b) They promote growth of body
space filling model of tissues by regulating protein
triiodothyroxine(T3) synthesis.
c) They regulate the development
of mental faculties.
d) They enhance some actions of
neuro-transmitters, adrenaline
The structural formula and the and noradrenalin.
space filling model of thyroxine(T4)
e) They help in maintaining body temperature by regulating heat
production.
f) They regulate the urine output by controlling the working of kidneys.
g) They simulate tissues Amphibian
differentiation; hence, they help Metamorp
in metamorphism of tadpole into hosis
adult frog.

Thyrocalcitonin (TCT). The thyrocalcitonin or calcitonin influences


the calcium homeostasis in the body. It then lowers the calcium level by
inhibiting the release of calcium ions from the bones. Thus, calcitonin
acts antagonistically to the action of parathyroid hormone on calcium
metabolism.

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Synthesis of the thyroid hormones, as seen on an individual thyroid
follicular cell.
Hyperthyroidism
Hyperthyroidism is a condition of the thyroid. It occurs when the
thyroid makes too much T4, T3, or both.
Causes
A variety of conditions can cause hyperthyroidism. Graves' disease, an
autoimmune disorder, is the most common cause of hyperthyroidism. It
causes antibodies to stimulate the thyroid to secrete too much hormone.
Graves disease occurs more often in women than in men. It tends to run
in families, which suggests a genetic link.
Other causes of hyperthyroidism include:
excess iodine, a key ingredient in T4 and T3
thyroiditis, or inflammation of the thyroid, which causes T4 and T3
to leak out of the gland
tumors of the ovaries or testes
benign tumors of the thyroid or pituitary gland

Signs & Symptoms


High amounts of T4, T3, or both can cause an excessively high
metabolic rate. This is called a hyper metabolic state. When in a hyper
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metabolic state, you may experience a rapid heart rate, elevated blood
pressure, and hand tremors. You may also sweat a lot and develop a low
tolerance for heat. Hyperthyroidism can cause more frequent bowel
movements, weight loss, and, in women, irregular menstrual cycles.
Visibly, the thyroid gland itself can swell into a goiter, which can be
either symmetrical or one-sided. Eyes may also appear quite prominent,
which is a sign of exophthalmos, a condition thats related to Graves
disease.
Other symptoms of hyperthyroidism include:
increased appetite
nervousness
restlessness
inability to concentrate
weakness
irregular heartbeat
difficulty sleeping
fine, brittle hair
itching
hair loss
nausea and vomiting
Illustration depicting enlarged
breast development in men thyroid that may be associated
with hyperthyroidism

The following symptoms require immediate medical attention:


dizziness
shortness of breath
loss of consciousness

fast, irregular heart rate

Hyperthyroidism can also cause atrial fibrillation, a dangerous


arrhythmia that can lead to strokes, as well as congestive heart failure.

Diagnosis
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The common signs of hyperthyroidism:
weight loss
rapid pulse
elevated blood pressure
protruding eyes
enlarged thyroid gland
Other tests may be performed to further evaluate your diagnosis. These
include:

Cholesterol test
Your doctor may need to check your cholesterol levels. Low cholesterol
can be a sign of an elevated metabolic rate, in which your body is
burning through cholesterol quickly.
T4, free T4, T3
These tests measure how much thyroid hormone (T4 and T3) is in your
blood.
Thyroid stimulating hormone level test
Thyroid stimulating hormone (TSH) is a pituitary gland hormone that
stimulates the thyroid gland to produce hormones. When thyroid
hormone levels are normal or high, your TSH should be lower. An
abnormally low TSH can be the first sign of hyperthyroidism.

Triglyceride test
Your triglyceride level may also be tested. Similar to low cholesterol,
low triglycerides can be a sign of an elevated metabolic rate.

Thyroid scan and uptake


This allows your doctor to see if your thyroid is overactive. In
particular, it can reveal whether the entire thyroid or just a single area of
the gland is causing the over activity.
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Ultrasound
Ultrasounds can measure the size of the entire thyroid gland, as well as
any masses within it. Doctors can also use ultrasounds to determine if a
mass is solid or cystic.

CT or MRI scans
A CT or MRI can show if a pituitary tumor is present thats causing the
condition.

How to treat hyperthyroidism


Medication
Antithyroid medications, such as methimazole (Tapazole), stop the
thyroid from making hormones. They are a common treatment.

Radioactive iodine
Radioactive iodine effectively destroys the cells that produce hormones.
Common side effects include dry mouth, dry eyes, sore throat, and
changes in taste.

Surgery
A section or all of your thyroid gland may be surgically removed. You
will then have to take thyroid hormone supplements to prevent
hypothyroidism, which occurs when you have an underactive thyroid
that secretes too little hormone. Also, beta-blockers such
as propranolol can help control your rapid pulse, sweating, anxiety, and
high blood pressure

What you can do to improve symptoms


Eating a proper diet, with a focus on calcium and sodium, is important,
especially in preventing hyperthyroidism.

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Hyperthyroidism can also cause your bones to become weak and thin,
which can lead to osteoporosis. Taking vitamin D and calcium
supplements during and after treatment can help strengthen your bones.

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Hypothyroidism
Hypothyroidism is a condition where your thyroid gland does not make
enough thyroid hormone. Low levels of thyroid hormone interfere with
the bodys ability to perform normal metabolic functions such as
efficient use of energy from food products, regulation of many chemical
reactions in the body, and maintenance of healthy cells, bones and
muscles, to name a few.

Causes
The most common causes are surgical removal of your thyroid,
autoimmune diseases, and radiation treatment.

Surgical Removal
This may be necessary to treat hyperthyroidism, or tumors of the
thyroid gland. Hypothyroidism will occur when the entire gland is
removed.

Autoimmune Diseases
These diseases cause the production of antibodies that attack your
thyroid gland. Autoimmune thyroiditis, which can appear suddenly or
develop over several years, is more common in women. Hashimotos
thyroiditis and atrophic thyroiditis are the most common types.

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Radiation Treatment
Radiation treatment for Hodgkin lymphoma and cancers of the head and
neck can injure the thyroid gland. If this occurs, the gland cannot
produce enough thyroid hormone to keep your metabolism running
smoothly. Radioactive iodine (I-131) destroys the thyroid gland and can
be used to treat people with Graves disease and thyroid cancer. Graves
disease is an autoimmune disease that causes hyperthyroidism.

Other Causes of Hypothyroidism


Congenital Hypothyroidism
Some children are born without a thyroid gland or they may have one
that doesnt function properly.

Viral or Autoimmune Thyroiditis


When antibodies or viruses attack your thyroid, thyroid hormones can
leak out. Sometimes all of the thyroids hormones are released into your
blood at one time. When this happens, symptoms of thyroid excess or
hyperthyroidism occur.

Medications
Lithium (used to treat bipolar disease), amiodarone (medication with
high iodine content used to treat serious ventricular arrhythmias,
interleukin 2 (anti-viral and anti-cancer agent), and interferon alpha
(anti-viral agent) are medications that can cause hypothyroidism. This is
more likely to occur in people who have a genetic tendency for
autoimmune thyroid disease.

Pituitary Disease
The pituitary is the master gland that signals the thyroid how much
hormone it needs to produce. If the pituitary is damaged by trauma,
stroke, or tumor, the signal to release thyroxine can stop. This causes the
thyroid to stop making thyroid hormone.

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Not Enough or Too Much Iodine
The thyroid gland needs iodine to make T3 and T4. Iodine had to be
obtained in the diet. Too little iodine can cause hypothyroidism and,
ironically, too much iodine can block the thyroids ability to make
thyroid hormone.

Infiltration
Diseases like amyloidosis can cause the thyroid to become
overwhelmed by abnormal proteins where the cells cannot function
normally.

Groups at Higher Risk for Hypothyroidism


The following groups are at a greater risk for developing
hypothyroidism:
women over age 50.
people with autoimmune diseases or a parent or grandparent with
an autoimmune disease.
people given radioactive iodine or radiation therapy
people treated with antithyroid medication
those with a history of radiation to the neck and upper chest people
with a partial thyroidectomy (removal of the thyroid)
post-partum females

What Are the Symptoms?


There are no symptoms that are unique to hypothyroidism. There may
be no symptoms early in the disease process. Long standing, untreated
hypothyroidism can cause obesity, joint pain, heart disease, and
infertility. Other symptoms can include:
increased sensitivity to cold
constipation
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depression
fatigue
weakness
heavier menstrual flow
brittle hair and nails
If left untreated, the following symptoms can occur:
hoarseness
puffiness of the face, hands, and feet
slowed speech
decreased taste and smell
thin eyebrows
thickened skin
coma (called myxedema coma)

How Is It Diagnosed?
Your doctor first conducts a physical exam and reviews of your medical
history. This can reveal any procedures like thyroid surgery or radiation
treatments connected to hypothyroidism. Family history might reveal a
close relative with autoimmune disease. Medication history might be
positive for drugs, such as lithium and amiodarone that can cause the
condition.
Because hypothyroidism is most often found in women over age 50,
some doctors advocate thyroid function screening for this group.
Doctors also may suggest screening women of childbearing age.
Blood tests also are common. These include:
thyroid function tests: T4, T3RU and TSH
tests for pituitary function: TSH
cholesterol (can be elevated)
CBC (may show anemia)
liver enzymes (can be elevated)
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prolactin (can be elevated)
electrolytes (sodium can be low)
In hypothyroidism, T4 is low and TSH is high. This means the pituitary
is sending more TSH to stimulate the thyroid, but the thyroid does not
respond. A low TSH indicates the pituitary may be the cause of
hypothyroidism.

Treatment Options for Hypothyroidism


A common treatment is to replace thyroxine with a specific synthetic
thyroid hormone (levothyroxine). This hormone is safe and affordable,
but determining the right dosage often takes time. Your metabolic rate
has to be returned to normal. Raising it too quickly can cause
palpitations and make some medical problems like coronary artery
disease and atrial fibrillation worse. Symptoms of thyroid hormone
excess are:
shakiness or tremors
palpitations
insomnia
increased appetite
Diets rich in soy and high fiber can interfere with levothyroxine
absorption. Medications and supplements also can reduce absorption.
These include:
calcium supplements
iron supplements
cholestyramine
aluminum hydroxide (present in some antacids)

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History

H
istorical references to what we now know as the thyroid gland
arise early in medical history. In Ayurvedic medicine, the
book Sushruta Samhita written about 1500 BC mentions the
disease goitre as 'Galaganda' along with its treatment. In 1600
BC the Chinese were using burnt sponge and seaweed for the treatment of
goiters (enlarged thyroid glands). Celsus first described a bronchoceole (a
tumors of the neck) in 15 AD. Around this time Pliny referred to epidemics
of goitre in the Alps and also mentioned the use of burnt seaweed in their
treatment, in the same way as the Chinese had done 1600 years earlier. In
150 AD Galen, an instrumental figure in the transition from ancient to
modern medicine, referred to 'spongia usta' (burnt sponge) for the treatment
of goitre. He also suggested (incorrectly, as it turns out) that the role of the
thyroid was to lubricate the larynx.
There are several findings that evidence a great interest for thyroid disorders
just in the Medieval Medical School of Salerno. Rogerius Salernitanus, the
Salernitan surgeon and author of "Post mundi fabricam" (around 1180) was
considered at that time the surgical text par excellence all over Europe. In
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the chapter "De bocio" of his magnum opus, he describes several
pharmacological and surgical cures, some of which nowadays are
reappraised as scientifically effective.
It was not until 1475 that Wang Hei anatomically described the thyroid
gland and recommended that the treatment of goitre should be dried
thyroid. Paracelsus, some fifty years later, attributed goitre to mineral
impurities in the water.

In modern times, the thyroid was identifies in 1656 by the anatomist


Thomas Wharton. In 1656 Thomas Wharton named the gland the
thyroid, meaning shield, as its shape resembled the shields commonly
used in Ancient Greece.
In 1909, Theodor Kocher from Switzerland won the Nobel Prize in
Medicine for his work on the physiology, pathology and surgery of the
thyroid gland.

Thyroid in Other Animals

T
he thyroid gland is found in all vertebrates. In fish, it is
usually located below the gills and is not always divided into
distinct lobes. However, in some teleosts, patches of thyroid
tissue are found elsewhere in the body, associated with the
kidneys, spleen, heart, or eyes.
In tetrapods, the thyroid is always found somewhere in the neck region.
In most tetra pod species, there are two paired thyroid glands - that is,
the right and left lobes are not joined together. However, there is only
ever a single thyroid gland in most mammals, and the shape found in
humans is common to many other species.
In larval lampreys, the thyroid originates as an exocrine gland, secreting
its hormones into the gut, and associated with the larva's filter-feeding
apparatus. In the adult lamprey, the gland separates from the gut, and
becomes endocrine, but this path of development may reflect the
evolutionary origin of the thyroid. For instance, the closest living
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relatives of vertebrates, the tunicates and Amphioxus, have a structure
very similar to that of larval lampreys (the endostyle), and this also
secretes iodine-containing compounds (albeit not thyroxine).

Characteristic changes in the facial skin of a


Labrador Retriever with hypothyroidism

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Case Study

Bibliography
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i. Other Animals. Thyroid. 27 Jul. 2016. 1 Aug 2016.
<https://en.wikipedia.org/wiki/Thyroid#Other_animals>
ii. History Thyroid. 27 Jul. 2016. 1 Aug 2016
<https://en.wikipedia.org/wiki/Thyroid#History>
iii. Sharma, Dr. J.P. Comprehensive Biology Class XI: Chemical Coordination and
Integration, 1004, 1005.
iv. Utiger, Robert D. Hypothyroidism. Encyclopdia Britannica. Encyclopdia
Britannica Online. Encyclopdia Britannica Inc., 2016. Web. 21 Jul. 2016
<https://www.britannica.com/science/hypothyroidism>
v. Hyperthyroidism. 3 Aug. 2016
<http://www.healthline.com/health/hyperthyroidism>

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