Tipping the scales: Understanding thyroid imbalances
Ann Crawford PhD, RN
Helene Harris MSN, RN

Nursing2015 Critical Care
January 2013 
Volume 8  Number 1
Pages 23 - 28
  PDF Version Available!

Thyroid hormones affect overall metabolism and electrolyte balance. Alterations in thyroid hormone function can cause widespread and potentially life-threatening effects. This article reviews hyperthyroidism and hypothyroidism and what you need to know about each condition. For details on this endocrine gland, see About the thyroid.Hyperthyroidism is the clinical syndrome that results when tissues are exposed to high levels of circulating thyroid hormone. In most cases, hyperthyroidism is due to hyperactivity of the thyroid gland.1 This common endocrine disorder can occur at any age, although patients typically are diagnosed between ages 20 and 40. Women are much more likely to be diagnosed with a form of hyperthyroidism than men.2,3 The increased levels of circulating thyroid hormones increase sympathetic nervous system activity and increase metabolic rate, causing many of the clinical manifestations of hyperthyroidism.1Thyroid hormone overstimulation on the cardiovascular system causes "fight-or-flight" types of responses, including an increase in heart rate, stroke volume, myocardial contractility, and BP.1,2 No matter what the cause, manifestations of overproduction of thyroid hormones are termed thyrotoxicosis. However, thyrotoxicosis isn't synonymous with hyperthyroidism and thyrotoxicosis can occur without hyperthyroidism. For a list of the manifestations of hyperthyroidism, see Clinical manifestations of hyperthyroidism and hypothyroidism.Elevated thyroid hormone levels increase the body's metabolic rate and affect the metabolism of proteins, fats, and carbohydrates. Because of this, although the patient has an increased appetite and food intake, energy needs exceed the supply and the person loses weight. With the high metabolic rate, protein degradation exceeds protein synthesis, causing a negative nitrogen balance. Fat metabolism is increased, reducing fat stores. Sustained hyperthyroidism leads to more chronic nutritional deficits.1,2 Hypersecretion of thyroid

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