ADH & Thyroid Disorders

• ADH regulates?

  Body fluid balance
• ADH - works with kidneys to manage the amount of water released from the body and in general, decreases the production of urine.
• ADH - a peptide hormone produced in the brain
• Hypothalamus gland - where ADH is produced
• Pituitary gland - where ADH is stored
• ADH - regulates how the kidneys concentrate urine or retain water
• ADH PROMOTES the reabsorption of water in the kidneys and DECREASES the excretion of water in the urine.
• ADH - helps conserve the fluid volume in the body and decreases water dilution of the urine caused by certain health conditions.
• DESMOPRESSIN - a synthetic and more potent version of vasopressin, is a first-line therapy for diabetes insipidus.
• LOW ADH LEVELS in diabetes insipidus can result in excessive urination and thirst
• Antidiuretic hormone drugs

  • Vasopressin
  • Desmopressin
• ADH Indications

  • Diabetes insipidus
  • Von Willebrand’s disease
  • Hemophilia A
  • Abdominal distension before an X-ray of after surgery
  • Enuresis (bedwetting)
  • Nocturia (excessive nighttime urination)
• Severe but rare symptoms of ADH

  1. Low sodium levels
  2. Mental and mood changes
  3. Allergic reaction
• Hyponatremia - can be caused by ADH hormones. Serum sodium concentrations should be measured before starting desmopressin and monitored during the treatment course.
• ADH should not be taken in combination with certain medications such as:

  1. intranasal corticosteroid
  2. oral corticosteroids
  3. inhaled corticosteroids
  4. loop diuretics
  5. thiazide diuretics
  6. tricyclic antidepressants
  7. NSAIDs
  8. opioid analgesics because they can enhance the effect of ADH.
• thyroid gland - a small organ, about 2-inch long, that’s located in the front of the neck, wrapped around the windpipe (trachea).
• HYPERTHYROIDISM - When the body makes too much thyroid hormone
• HYPOTHYROIDISM - If the body makes too little thyroid hormone
• FUNCTIONS OF THYROID GLAND

  1. Metabolism
  2. Affect how deep we breathe, how fast our heart beats, gaining or losing weight.
  3. Control our body temperature, cholesterol levels and menstrual cycle
• Grave's disease

  • Your immune system attacks your thyroid. This makes your thyroid create too much thyroid hormone.
• Females - a sex where Grave's disease are more common when it's hereditary
• Thyroid nodules

  • A lump or growth of cells in your thyroid gland.
  • They can produce more hormones than your body needs.
• Thyroiditis - Inflammation of your thyroid gland, which may be painful or painless (silent). It may happen within a year of delivering a baby (postpartum thyroiditis).
• After you experience thyroiditis, your thyroid may be unable to recover, which would lead to hypothyroidism.
• Receiving IV iodinated contrast (iodine “dye”) may also cause hyperthyroidism.
• AMIODARONE - a medication that contains a high amount of iodine, may also cause hyperthyroidism.
• THIONAMIDES

  • Carbimazole
  • Propylthiouracil
• Hyperthyroidism - indication of THIONAMIDES
• Less but more common side effects of THIONAMIDES

  1. Decrease WBC count (agranulocytosis)
  2. Hepatotoxicity
  3. Pancreatitis
  4. Edema
  5. Vasculitis
• Since THIONAMIDES can cause agranulocytosis, the patient is prone to develop an infection
• Antithyroid drugs typically reduce levels of both triiodothyronine (T3) and thyroxine (T4), but levels of T3 may take longer to return to normal.
• At what trimester can a pregnant woman only use THIONAMIDES? However, it may cause thyroid problems in the baby.

  1st
• HYPOTHYROIDISM

  • PRIMARY CAUSE: is a condition that directly impacts the thyroid and causes it to create low levels of thyroid hormones.
• HYPOTHYROIDISM

  • SECONDARY CAUSE: something that causes the pituitary gland to fail, which means it can’t send thyroid stimulating hormone (TSH) to the thyroid to balance out the thyroid hormones.
• HASHIMOTO’S DISEASE: - the most common of these primary causes in HYPOTHYROIDISM; an autoimmune condition.
• Hashimoto's disease - Body’s immune system attacks and damages the thyroid. This prevents the thyroid from making and releasing enough thyroid hormone.
• OTHER PRIMARY CAUSES OF HYPOTHYROIDISM

  • Thyroiditis (inflammation of the thyroid).
  • Treatment of hyperthyroidism (radiation and surgical removal of the thyroid).
  • Iodine deficiency (not having enough iodine — a mineral your thyroid uses to make hormones – in your body).
  • Hereditary conditions (a medical condition passed down through your family).
  • In some cases, thyroiditis can happen after a pregnancy (postpartum thyroiditis) or a viral illness
• Levothyroxine - treatment for underactive thyroid
• Levothyroxine - a drug for hypothyroidism that does not usually have any side effects because the tablets simply replace a missing hormone.
• When taking LEVOTHYROXINE, start at a low dose, then gradually increasing the dose.