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A Synopsis of Endocrinology and Metabolism by David G. Ferriman

By David G. Ferriman

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Treatment with thyroxine must be life-long. 3. Severe Iodine Deficiency Iodine deficiency if sufficiently severe presents the thyroid with a problem in the synthesis of an adequate amount of thyroxine. This is achieved through the feed-back mechanism, by an increased output of thyroxine, a compensatory increase in the size 32 DISEASES OF T H E THYROID Severe Iodine Deficiency, continued. of the thyroid, and a greatly increased turnover of iodine in the gland. Substantial goitres may be produced.

Useful when uptake results are in borderline hypothyroid range, and in distinguishing between primary hypothyroidism and hypothyroidism secondary to hypopituitarism. , 10 units daily for 3 days); uptake is increased in normal subjects and in subjects with hypothyroidism secondary to hypopituitarism, but it is unaffected in primary hypothyroidism. 4. —The first two tests described below have important advantages. They are in vitro tests calling for attendance by patients for a single withdrawal of blood, METHODS OF INVESTIGATION 29 and patients receive no irradiation; they are particularly suitable for use in children and in pregnancy.

Raised serum cholesterol. 3. A high suppressible 132 I uptake and a high 48-hour P B I 1 3 1 may be found with partial absence of thyroid and incomplete enzyme deficiencies. Low P B I except in forms associated with abnormal iodinated proteins. 3. —Adult life. —Auto-immune thyroiditis, overdosage with antithyroid drugs, 131 I therapy. —The onset is insidious, recognition being delayed for a year or more in a large proportion of cases. Lassitude, mental disturbance from simple dulling to frank psychosis, dryness of skin and loss of hair, sensitivity to cold, increase in weight, paraesthesiae, carpal tunnel syndrome, constipation.

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