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Chapter 17 - Thyroid dysfunction and critical care

from Section 3 - Endocrine disorders in the critically ill

Published online by Cambridge University Press:  06 July 2010

By
Brian Mullan
Edited by
George M. Hall ,
Jennifer M. Hunter  and
Mark S. Cooper
George M. Hall
Affiliation:
St George's Hospital, London
Jennifer M. Hunter
Affiliation:
University of Liverpool
Mark S. Cooper
Affiliation:
University of Birmingham
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Summary

Thyroid hormone is essential for the regulation of tissue metabolism. Thyrotropin releasing hormone is a tripeptide which is produced in the parvocellular region of the paraventricular nuclei of the hypothalamus. A wide variety of medications which may be used during critical illness can affect thyroid hormone physiology and the interpretation of thyroid function tests. Hyperthyroidism is the consequence of excessive thyroid hormone action. Hypothyroidism results from under secretion of thyroid hormone from the thyroid gland. It can be classified as primary, secondary and tertiary. The most common cause of primary hypothyroidism is chronic autoimmune thyroiditis. Other causes include surgical removal of the thyroid gland, thyroid gland ablation with radioactive iodine, infiltrative diseases, iodine deficiency, congenital enzymatic defects which affect thyroid hormone synthesis and drug-induced effects. Secondary and tertiary hypothyroidisms are usually due to pituitary and hypothalamic disorders respectively.

Keywords

biguanidesdiabetes mellitusglucosidase inhibitorssulphonylureassynthetic amylin analoguesreceptor agonistsmeglitinidesinhibitorsthiazolidinediones
Type
Chapter
Information
Core Topics in Endocrinology in Anaesthesia and Critical Care , pp. 168 - 174
Publisher: Cambridge University Press
Print publication year: 2010

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