Janelle. a 30-year-old woman, presents at her primary care office complaining of feeling nervous and anxious. She states that she even feels as if her heart is racing because she is “so stressed out.” Janette would like to be prescribed anti-anxiety medication.
Janelle’s height and weight measurements reveal she has lost 15 pounds in the last 6 months. She attributes her weight loss to stress.
The primary care provider (PCP) examines Janette and notes her resting heart rate is 84 beats per minute and blood pressure is 144/88 mm Hg. The PCP notes slight tremors in Janelle’s hands, and an area in her neck appears to be enlarged compared to its appearance in previous visits. Janette lists further complaints including hair loss, diarrhea, and “feeling hot all the time.”
The PCP decides to have several blood laboratory tests completed. All results are normal except the following: significantly elevated thyroid hormone levels and undetectable TSH and TRH. Further screening reveals elevated thyroid-stimulating antibodies.
The PCP informs Janelle that her thyroid gland may need to be removed. If removal is necessary, thyroid hormone replacement medication will be prescribed.
1. What endocrine disorder is Janelle suffering from?
2. What led you to your conclusion?
3. Janelle says she cannot understand how one hormone can be the cause of so many symptoms: weight loss. tremors, hair loss. increased heart rate. feeling hot. etc. How would you explain the systemic effects of hormones to Janette?
