27.1 Introduction to the Thyroid and Parathyroid

The thyroid and parathyroid glands play crucial roles in regulating metabolism and calcium balance. Thyroid hormones control your body's energy use, while parathyroid hormone manages calcium levels in your blood and bones.

Understanding these glands is key for nurses. You'll need to recognize symptoms of thyroid disorders, like fatigue or anxiety, and know how to interpret lab tests. This knowledge helps you provide better care for patients with endocrine issues.

Thyroid and Parathyroid Glands

Thyroid and parathyroid hormone roles

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• Thyroid hormones T3 and T4 regulate metabolism by increasing basal metabolic rate (BMR), stimulating carbohydrate and fat metabolism, increasing protein synthesis and breakdown, and enhancing growth and development
• Parathyroid hormone (PTH) regulates calcium balance by increasing serum calcium levels through stimulating osteoclasts to release calcium from bones, enhancing calcium reabsorption in the kidneys, and activating vitamin D to increase calcium absorption in the intestines, while also decreasing serum phosphate levels by inhibiting renal reabsorption

Hypothyroidism and hyperthyroidism symptoms and causes

• Hypothyroidism (underactive thyroid) symptoms include fatigue, weight gain, cold intolerance, dry skin, hair loss, constipation, bradycardia, hypothermia, delayed reflexes, depression, and memory impairment, caused by autoimmune disorders (Hashimoto's thyroiditis), iodine deficiency, surgical removal or radiation therapy of the thyroid gland, or certain medications (lithium, amiodarone)
• Hyperthyroidism (overactive thyroid) symptoms include nervousness, anxiety, irritability, heat intolerance, increased sweating, tachycardia, palpitations, tremors, weight loss despite increased appetite, diarrhea, and menstrual irregularities, caused by autoimmune disorders (Graves' disease), thyroid nodules or goiter, excessive iodine intake, or thyroiditis (inflammation of the thyroid gland)

Diagnostic tests for thyroid and parathyroid function

• Thyroid function tests include:
  1. Thyroid-stimulating hormone (TSH): elevated in hypothyroidism, decreased in hyperthyroidism
  2. Free T4 (thyroxine): decreased in hypothyroidism, elevated in hyperthyroidism
  3. Free T3 (triiodothyronine): may be decreased in hypothyroidism or elevated in hyperthyroidism
  4. Thyroid antibodies (anti-TPO, anti-thyroglobulin): presence indicates autoimmune thyroid disorders
• Parathyroid function tests include:
  1. Serum calcium: elevated in hyperparathyroidism, decreased in hypoparathyroidism
  2. Serum phosphate: decreased in hyperparathyroidism, elevated in hypoparathyroidism
  3. Parathyroid hormone (PTH): elevated in primary hyperparathyroidism, decreased in hypoparathyroidism
  4. 24-hour urine calcium: increased in hyperparathyroidism, decreased in hypoparathyroidism