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1. Clinical usefulness of Thyroid Hormones Presented by Shayan Shakeel

2. Contents Function thyroid hormone Regulation thyroid hormone Synthesis of thyroid hormone Transportation thyroid hormone Clinical usefulness thyroid hormone Suppression and stimulation test

3. Anabolic hormones (growth hormones and insulin) Catabolic hormone (thyroid hormone mainly T3 )

4. Stimulation and Regulation of thyroid hormone

5. Synthesis of thyroid hormone Four step Step no 1 Iodide uptake Step no 2 Oxidation of iodide Step no 3 Oragnification Step no 4 Coupling

6. Thyroid hormone in blood More than 99.8% of thyroid hormone circulating in blood is bound firmly to three plasma proteins, thyroxine-binding globulin (TBG), transthyretin (TTR), and albumin and remaining is free and in unbounded from which is avaliable for the cells directly.

7. Thyroid hormone functions Increases basal metabolic rate. Essential for heat generation and maintenance. Enhances heart ate and cardiac output. Help in managing cholesterol levels. Assists in production of protein necessary for body functioning. Regulate bone growth.

8. Clinical usefulness of thyroid hormone Diagnosis of Thyroid Disorders Thyroid hormones are integral to the diagnostic process in endocrinology. Blood tests measuring levels of T4, T3, and thyroid-stimulating hormone (TSH) are used to assess thyroid function. TSH is particularly important because it reflects the pituitary gland's response to the levels of T4 and T3 in the blood, providing a sensitive method for detecting even minor abnormalities in thyroid function . free t3 and free t4 are more specific and sensitive markers of thyroid abnormalities like hypo or hyperthyroidism .

9. Causes of hypothyroidism 3 types of causes Primary thyroid gland refuse to make hormone or Hashimoto disease . Secondary pituitary refuse to make tsh due to certain tumors. Tertiary due to disfuctioning of thyroid hormone

10. Causes of hyperthyroidism Primary hyperthyroidism Graves disease muti nodular goiter or adenoma. Secondary hyperthyroidism TSH secreting adenoma .

11. Suppression and stimulation test Suppression and stimulation tests are dynamic tests used in the diagnosis and assessment of various thyroid disorders. These tests help evaluate the function of the thyroid gland by either stimulating it to produce hormones or suppressing its hormone production. Each test provides valuable insights into how the thyroid is working and helps clarify the diagnosis when standard static tests (like TSH, T4, and T3 levels) might be inconclusive or show borderline results

12. Suppression 1. Thyroid Suppression Test Purpose: The thyroid suppression test is used to assess thyroid function and to check for thyroid autonomy, which is the thyroid's ability to function independently of pituitary control. How it works : This test involves administering thyroid hormone medication (usually in the form of synthetic T4, levothyroxine) to suppress the secretion of TSH from the pituitary gland. In a healthy person, when exogenous thyroid hormone is added, the pituitary gland should respond by lowering TSH production, reflecting a normally functioning feedback loop.

13. Suppression test Clinical Use: Diagnosis of thyroid autonomy : In conditions like Graves' disease or toxic multinodular goiter, the thyroid gland may not appropriately respond to TSH suppression, continuing to produce thyroid hormones despite high levels of circulating levothyroxine. This non-response suggests the presence of autonomously functioning of thyroid tissue. Evaluation of thyroid nodules: A suppression test can be used to check if thyroid nodules are 'hot' or 'cold'. 'Hot' nodules that produce thyroid hormone may not suppress with exogenous hormone administration, indicating autonomy.

14. stimulation test Purpose : The thyroid stimulation test evaluates the reserve capacity of the thyroid gland to produce thyroid hormone when stimulated by Thyrotropin-Releasing Hormone (TRH) or Thyroid-Stimulating Hormone (TSH). How it works : This test can be conducted in two main ways: TRH stimulation test : TRH is injected intravenously, and the TSH response is measured at various intervals afterward. This is used to assess pituitary function and its ability to respond to TRH by secreting TSH. Recombinant human TSH ( rhTSH ) test : Used primarily in patients with differentiated thyroid cancer who are being monitored for recurrence. Here, rhTSH is administered to stimulate any remaining thyroid cells to produce thyroglobulin, a protein that can be measured to assess the presence of thyroid cancer cells without requiring thyroid hormone withdrawal.

15. stimulation test Clinical Use : Assessment of hypothyroidism : The TRH test can differentiate between primary (thyroidal) and secondary (pituitary) hypothyroidism based on how TSH responds to TRH. Monitoring thyroid cancer: The rhTSH test helps avoid the symptoms of hypothyroidism that come from withdrawing thyroid hormone treatments to conduct cancer surveillance.

16. Thank you Shayan shakeel Google ai Afip manual 3/1/20XX SAMPLE FOOTER TEXT 20