Acknowledgement

I would like to express a deep sense of thanks and

gratitude to our principal Mrs Mukta ……, for her in
extending every possible support for the completion of
this project. This project would not been feasible without
the proper guidance of biology teacher Mrs Sharmistha
Mohanty, who guided me throughout this project in
every possible way. Her suggestions and her
instructions have served as a major contributor towards
the completion of this project.
I also thank my parents for their motivation and support.
I must thank my classmates for their timely support and
help for the compilation of this project.
 Contents

1. Thyroid gland
2. Hormones of the thyroid gland
3. Thyroid disorders
a. Hyperthyroidism
b. Hypothyroidism
4. History
5. Other animals
6. Case Study
7. Bibliography
 The Thyroid gland
The thyroid gland is the largest endocrine gland located
anterior of the thyroid cartilage of the larynx in the neck.
It is composed of two lobes which are located on the
either side 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 tissue contains small cluster of
specialized parafollicular cells or ‘C’ cells.
Each thyroid follicle is composed of follicular cells,
enclosing a cavity. The follicles are filled with a
homogeneous substance called colloid, composed of
glycoprotein, thyroglobulin. The thyroid gland can store
enough hormones in the collide to supply the body for
about two months.
The human thyroid as viewed from the front with arteries
visible.
Hormones of the Thyroid gland
The thyroid gland secretes three hormones:
Thyroxine or tetra-iodothyroxine (T4),
triiodothyroxine (T3), thyrocalcitonin (TCT)

by Unknown Author is licensed under

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 from the anterior pituitary, stimulates the
thyroid gland to secrete its hormone.

by Unknown Author is licensed under

Thyroxine (T4), and triiodothyroxine (T3) are usually

consider together under the name thyroid hormone (TH)
because they have similar effect on target cells. T3 and
T4 contains three and four iodine atoms respectively.
They are synthesized by the attaching iodine to the
amino acid tyrosine by the enzymatic action. T3 is
secreted in smaller amounts but is more active than T4
hormones. However, T4 is converted to T3 by removal
of one iodine atom in liver, kidney and in some other
tissues. The thyroid gland is the only gland that stores
its hormones in large quantity. The hormone is stored in
the collide that fills the follicles and is released into the
blood when required.
The structural and space filling model of T3:

The structural formula and space filling model of T4:

T4 and T3 performs the following functions:

a) They regulate the metabolic rate of the body and
thus maintains basic metabolic rate(BMR).
b) They promote growth of the body tissues by
regulating protein synthesis.
c) They regulate the development of mental faculties.
d) They enhance some actions of neuro transmitter,
adrenaline and noradrenaline.
e) They help in maintaining body temperature by
regulating heat production.
f) They regulate the urine output by controlling
working of kidneys.
g) They stimulate tissues differentiation; hence, they
help in metamorphism of tadpole into adult frog.

Thyrocalcitonin (TCT). The thyrocalcitonin or

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

Hyperthyroidism
Hyperthyroidism is a condition of the thyroid. It
occurs when the thyroid makes too much of T3, T4
or both.
Causes
A variety of conditions can cause hyperthyroidism.
Graves’s diseases, autoimmune disorder, is the
most common cause of hyperthyroidism. It causes
antibodies to stimulate the thyroid to secret too
much hormone. Graves’s disease occurs more
often in women than in men. It trends to run in
families, which suggests a genetic link.

Other causes of hyperthyroidism include:

a) Excess iodine, a key ingredient of T3 and T4.
b) Thyroiditis, or inflammation of thyroid, which
causes T3 and T4 to leak out of the gland
c) Tumours on ovaries or testis
d) Begin tumours of the thyroid and pituitary gland
Signs and symptoms:
High amount of T3, T4 or both can cause an
excessively high metabolic rate. This is called hyper
metabolic rate. When in a hyper metabolic state,
you may experience a rapid heart rate, elevated
blood pressure, and hand tremors. You may sweat
a lot and low tolerance of heat. Hyperthyroidism
may also cause more frequent bowel movement,
weight loss, and in women irregular menstrual
cycle.
Visibly the thyroid gland can swell into a goitre,
which can be either symmetrical or one sided. Eyes
 may also appear quit prominent, which is a sign of
exophthalmos, a condition that’s related to Graves’
disease.
Other symptoms of hyperthyroidism:
a) Increased appetite
b) Nervousness
c) Restlessness
d) Inability to concentrate
e) Weakness
f) Irregular heart beat
g) Difficulty sleeping
h) Fine, brittle hair
i) Itching
j) Hair loss
k) Nausea and vomiting
l) Breast development in men
The following symptoms require immediate medical
attention:
a) Dizziness
b) Shortness of breath
c) Loss of consciousness
d) Fast and irregular heart beat
Hyperthyroidism can also cause atrial fibrillation, a
dangerous arrhythmia that can lead to stokes, as well as
congestive heart failure.
Diagnosis
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 includes:
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 and T3
These test measure how much thyroid hormone 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 gland hormones are normal or
high, your TSH should be lower. An abnormally TSH can
be the first sign of hyperthyroidism.
Triglyceride test
Your triglyceride test should also be conducted. Similar
to low cholesterol, low triglyceride may also a sign of
elevated hyperthyroidism.
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.
Ultra sound
Ultrasound can measure the entire thyroid gland, as well
as any masses within it. Doctors can also use ultra
sound to determine if the mass is solid or cystic.
CT or MRI scan
A CT or MRI can show if a pituitary tumour is present
that causing the condition.
How to treat hyperthyroidism
Medication
Antithyroid medication, such as methimazole (Tapazole),
stop the thyroid from making hormones. They are
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 of all of your thyroid gland may be surgically
removed. You will have to take thyroid hormone
supplements to prevent hyperthyroidism, which occurs
when you have an underactive thyroid that secrets too
little hormone. Also, beta-blockers such as propranolol
can also help control your rapid pulse, sating anxiety,
and high blood pressure.
What can you do to improve symptoms:
Eating a roper diet, with a focus on sodium and calcium,
is important, especially in preventing hyperthyroidism.
Hyperthyroidism also makes your bone to become weak
and thin, which can lead to osteoporosis. Taking vitamin
D and calcium supplements during and after treatment
can help to strengthen your bones.

Hypothyroidism
Hypothyroidism is a condition where your thyroid gland
does not make enough thyroid hormone. Low level of
thyroid hormone interfere with the body’s 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 cause are surgical removal of your
thyroid, autoimmune diseases, and radiation treatment
Surgical removal
This may be necessary to treat hyperthyroidism, or
tumours of the thyroid gland. Hypothyroidism will occur
when the whole thyroid gland is removed.
Autoimmune diseases
These diseases cause the production of the antibodies
that attack your thyroid gland. Autoimmune thyroiditis
which can appear suddenly or develop over several
years is more common in women.
Radiation treatment
Radiation treatment for Hodgkin lymphoma and cancers
of head and neck can injure the thyroid. 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 Grave’s disease and thyroid
cancer. Grave’s disease is an autoimmune diseases that
causes hyperthyroidism.
Other causes of hypothyroidism
Congenital hypothyroidism
Some children are born without thyroid gland or they
may have one which does not perform properly.
Viral or autoimmune Thyroiditis
When antibodies or virus attack your thyroid, thyroid
hormones can leak out. Sometimes all of the thyroid
hormones are released into your blood at one time.
When this happens, symptoms of thyroid excess or
hyperthyroidism occurs.
Medication
Lithium used to treat bipolar disease, amiodarone
(medication with high iodine content used to treat
serious ventricular arrhythmias, interleukin 2 (antiviral
and anticancer 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 diseases.
Pituitary diseases
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 tumour, the signal to
release thyroxin will stop. This causes the thyroid to stop
making thyroid hormone.
Not enough or too much Iodine
The thyroid gland requires iodine to prepare T3, T4
hormones. Iodine had to be included in the diet. Too little
iodine may cause hypothyroidism, and ironically, too
much iodine can block the thyroid’s ability to make
thyroid hormone.
Infiltration
Diseases like amyloidosis can cause thyroid to become
overwhelmed by abnormal proteins where the cells
cannot function normally.
Groups at higher risk for hypothyroidism
The following groups are at higher risk for developing
hypothyroidism.
a) Women over 50 years of age
b) People with autoimmune disease or parent or
grandparent with autoimmune diseases
c) People given radioactive iodine or radiation therapy
d) People treated with antithyroid medication.
 e) Those with a history of radiation to the neck and
upper chest people with a partial thyroidectomy
(removal of thyroid)
f) Post-partum females.
What are the symptoms?
There are no symptoms that are unique to
hypothyroidism. There may be no symptoms early in the
diseases process. Long standing, untreated
hypothyroidism can cause obesity, joint pain, heart
diseases and infertility. Other symptoms can include:
a) increased sensitivity to cold
b) constipation
c) depression
d) fatigue
e) weakness
f) heavier menstrual flow
g) brittle hair and nail
if left untreated, the following symptoms can occur:
a) hoarseness
b) puffiness of the face, hands and feets
c) slowed speech
d) decreased taste and smell
e) thin eyebrows
f) thickened skin
g) coma (called “myxedema coma”)
how is it diagnosed?
Your doctor first conduct physical exam and reviews of
your medical history. This can reveal any procedures
like thyroid surgery or radiation treatments connected
hypothyroidism. Family history might reveal a close
relative with autoimmune diseases. Medication history
might be positive for drugs, such as lithium amiodarone
that can cause the condition.
Because hypothyroidism is commonly found in women
over 50 years of age, some doctors advocate thyroid
function screening for this group. Doctors also may
suggest screening women of childbearing age.
Blood Test are also common. This include:
 thyroid function tests- T3, T4, TSH
 test for pituitary function: TSH
 cholesterol (can be elevated)
 CBC (may show anaemia)
 Liver enzymes (can be elevated)
 Prolactin (can be elevated)
 Electrolysis (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 the thyroxine with a
specific synthetic thyroid hormone(levothyroxine). This
hormone is safe and affordable, but determining right
dosage may 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 diseases and atrial fibrillation worse.
Symptoms of thyroid hormones excess are:
 Shakiness or tremor
 Palpitations
 Insomnia
 Increased appetite.
 Diets rich in soya and high fibre can interfere with
levothyroxine absorption. This include:
 Calcium supplements
 Iron supplements
 Cholestyramine
 Aluminium hydroxide (present in some
antacids)

Case study
Name of the patient :- Shaila Madke
Age :- 37
Gender :- Female
Address :- Flat no 504 Building no A1 Shiv Shakti
Apartment, Nerul
Diagnosis: HYPOTHYROIDISM
Initial weight 98 Kg
Final weight 80 Kg
Doctor Consulted – Dr. Ayesha
Tests Taken -T3, T4, TSH

Person’s past and present condition

The person is now 37 years of age and was 34 years old
at the time of diagnosis. She was suffering from
hypothyroidism and obesity. She also faced the
problems of depression and fatigue.
She is now 80 kg of weight and is completely normal.
Her thyroid gland is functioning normally. She also feel
energetic and is mentally in better condition.
Family history
The person had no history of anyone suffering from
hypothyroidism. This shows that in this person’s
situation hypothyroidism was not due to genetic reason.
Reason behind hypothyroidism
According to the doctor the patient was suffering from
the hypothyroidism due to stress and improper lifestyle
such as improper sleeping habits.
Diagnosis
Her T3 and T4 results were not normal. So the doctor
prescribed Thyronom 50 mg tablets everyday before
breakfast.
She was also advised to take proper food in time, have
adequate sleep at least 8 to 9 hours of sleep. Do yoga
like pranayama and kapalbharti, also do regular walking
for half an hour for fresh refreshment of mental
condition.
Bibliography
 Necrt books
 Google
 www.doctorstoday.com
 www.nidk.com