Akademik Veri Yönetim Sistemi
Chronic Disease Follow-Ups for Adults in Primary Care, NOVA Publications , ss.71-79, 2022
The thyroid gland is an organ specialized for the production of thyroid hormones. The activity of the thyroid gland is controlled by the hypothalamus-pituitary-thyroid axis. The basic tests used to detect thyroid dysfunctions are TSH, fT4, fT3, thyroglobulin, thyroid specific autoantibodies, and calcitonin. Normal TSH ranges for young adults to middle-aged individuals are between 0.4 and 4.5 mU/L. TSH values increase physiologically with age. Thyroid hormones are transported in the blood bound to certain proteins such as TBG. The total T4 and T3 may be affected by various factors, and for this reason, the measurement of free forms (fT4 and fT3) is more frequently used. Thyroid function screening is not recommended in asymptomatic patients. In a patient with mild suspicion of thyroid dysfunction, screening with TSH alone could exclude primary hypothyroidism and hyperthyroidism. Hypothyroidism is a disease that occurs as a result of thyroid hormone deficiency or ineffectiveness. Hypothyroidism can be examined under two headings: central and primary hypothyroidism. If there is a problem in the secretion of TRH from the hypothalamus or the secretion of TSH from the pituitary, it is called central hypothyroidism. In primary hypothyroidism, the problem is in the secretion of hormones from the thyroid gland. It accounts for more than 95% of hypothyroidisms. Thyrotoxicosis is a general term that refers to an excess of thyroid hormone regardless of its source. Hyperthyroidism is thyrotoxicosis caused by increased hormone synthesis in the thyroid gland. The incidence of thyroid diseases in the community is quite common. In thyroid diseases, patients primarily apply to the primary care unit with non-specific complaints such as weakness, chills, heat intolerance, constipation, depression, palpitations and irritability. It is very important for family physicians to suspect thyroid dysfunction in patients with these complaints and to guide the patient with appropriate tests and clinical history.