Elevated GH, PRL, ACTH, TSH. BUT the most common are GH and PRL.
Elevated GH leads to Gigantism in children due to the excess GH before closure of epiphyses resulting in rapid long bone growth. Acromegaly in adults making bones very thick and very wide.
Elevated PRL leads to galactorrhea (milky needle discharge unrelated to breastfeeding), anovulation, amenorrhea, and infertility in women, and erectile dysfunction, low libido, low sperm count in men.
Elevated TSH leads to hyperthyroidism (goiter)
Elevated ACTH leads to Cushing Syndrome.
8. Hyperthyroidism- Excessive secretion of TH leading to excess T3, T4 or both. It has many causes such as thyroid tumors, trauma, iodine deficiency, infection, secondary to problems with hypothalamus or pituitary gland, BUT most common cause is autoimmune disease (Graves’ disease)
Graves- unknown etiology, but it is known that body produces antibodies to TH receptors resulting in excess production of T3, and T4.
Diagnostics. TSH will be low if thyroid gland is the problem, TSH will be high if pituitary is the problem.
Manifestations. Everything in the body speeds up, hypermetabolism leading to (negative nitrogen balance, lipid depletion, nutritional deficiency, high appetite, and weight loss) high SNS activity- Tachycardia, high CO and stroke volume leading to dysrhythmias MAINLY Atrial Fib. Goiter due hypertrophy of thyroid cells as a result of overactive thyroid. Agitation, irritation, short attention span, cyclic moods, hand tremors/sweating, fatigue, weakness, depression, brittle nails, heat intolerance and exophthalmos.
3 Main Complications.
Exophthalmos – antibodies also deposit in extraocular muscle causing inflammation and swelling, and abnormal cellular production leading to compression of veins leading to inability to drain fluid from eyes resulting in edema leading to high pressure which forces eyeballs outward.
Hearth disease – Tachycardia, Atrial fib., HF
Thyroid Storm or thyrotoxic crisis- High fever, tachypnea with respiratory distress, abdominal pain, GI, sweating, anxiety, irritation, confusion, Severe tachy. 120-200 bpm, frequent PVCs, Atrial fib, HF, pulmonary edema,