Case Study

Hypothyroidism pathophysiology

Hypothyroidism or underactive thyroid is a hypometabolic condition from deficiencies in T4 and T3 hormones caused by chronic autoimmune thyroiditis (Hahimoto’s disease) radioactive iodine, thyroid cancer, and inflammatory diseases, surgical therapy, deficiency of iodine and drugs interfering with synthesis of thyroid hormone. It leads to destruction of thyroid gland by lymphocytes attacking glands. It also occurs from deficiencies in TRH or TSH secretion caused by pituitary disease. It causes a negative feedback between serum T4 and T3 levels in relation to TSH secretion. The thyroid gland produces insufficient amounts of T3 and T4 hormones, which interferes with normal balancing of chemical reactions in the body and common among older women of more than 60 years. Hypothyroidism symptoms include dry skin, weight gain, constipation, fatigue, thyroid problems, joint pain, infertility, and heart diseases (Mayo clinic staff, 2016).

Diagnosing Hypothyroidism

(Garber et al. (2012) asserts that hypothyroidism is diagnosed through tests such as TSH, T4 tests, and anti-thyroid microsomal antibodies testing.

TSH testing

Doctor tests symptoms and results of thyroid stimulating hormone (TSH) in the blood where T3 and T4 hormones are released through stimulation of pituitary gland. The ranges vary with 04: normal, 2.5: at risk, 4.0: mild hypothyroidism, 10.0: hypothyroidism.

T4 testing

T4 testing measures levels of free T4 thyroid hormone available in blood tissues. People suffering from hypothyroid have high TSH levels and low T4 levels. T4 testing diagnoses primary hypothyroidism, which is a condition whereby the pituitary gland releases high levels of TSH to stimulate thyroid to produce additional hormones. As a result, poor functioning thyroid does not react to signals leading to high TSH levels and low T4 levels

Anti-thyroid microtonal antibodies testing

Immune system produces Microsomal antibodies, which attack thyroid cells leading to hypothyroidism. Specialists take a picture of destruction phase of thyroiditis after secretion and storage of thyroid hormones in the cells.

Why hyperthyroidism could result to hypothyroidism?

Hyperthyroidism condition leads to a release of excess thyroid hormone than required in the body by thyroid gland. Excess hormones damage body organs including pituitary gland, which releases hormones leading to underproduction of T3 and T4 hormones (Mayo clinic staff, 2016).

 Gastrointestinal bleeding, pathophysiology 

Gastrointestinal bleeding is a digestive tract disorder where blood is seen in the stool or vomit. Peptic ulcers, diverticulosis, colon polyps, hemorrhoids, cancerous tumors, and inflammatory bowel disease (IBD) cause GI bleeding. It often leads to loss of red blood cells and anemia.


Upper GI bleeding causes Esophageal varices associated with acute liver disease. The parenchyma of normal liver is replaced by sclerotic tissue blocking the flow, increases pressure of portal, and stimulates formation of collateral circulation. Signs of esophageal varices include liver cirrhosis, hepatitis, B, C and D, toxins in the stomach, schistosomiasis, congestive heart failure, and inheritable etiologies.

Helicobacter pylori infection causes peptic ulcer leading to development of ulcer disease causing bleeding of upper GI. Smoking accelerates infection of Concomitant H.Pylori, which leads to peptic ulcer disease.

Colonic diseases causes gastrointestinal bleeding by disrupting stomach mucus thus providing a way of communication between blood vessels and lumen in the gut. Infections such as colitis and malignancy take advantage of the narrow and small blood vessels to cause diseases in the colon. Various drugs such as aspirin, oral anticoagulants, steroids, and chemotherapy agents cause variceal bleeding among cirrhosis patients (EB Medicine, 2016).

The blood type B, which blood type is type B compatible and incompatible with?

Blood type B has antigens A and B thus it is compatible with blood type B and AB. It is incompatible with blood type O and A (John Hopkins University, hospital and Health system, 2016).













EB Medicine. (2016).Epidemiology, etiology, and pathophysiology. EB medicine. Retrieved             from  d=15    01

Garber,J.,Cobin,R.,Gharib,H.,Hennessey,J.,Klein,I.,Mechanick,J.(2012).Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of      clinical endocrinologists and the American thyroid association.ATA/AACE Guidelines,1-       41.

John Hopkins University, Hospital, and health system. (2016).Blood Compatibility.          Comprehensive transplant center. Retrieved from   

Mayo clinic staff. (2016).Diagnosis. Hypothyroidism (underactive thyroid).Retrieved from     treatment/diagnosis/dxc-20155353





Leave a Reply