Thyroid #tipsfornewdoctors – sick euthyroidism

The number of TFTs checked in hospital has ⬆️⬆️⬆️ in recent years.

We are always looking for easily reversible thyroid problems as the cause for symptoms, but how often do we find this? In one study, ~15% of inpatients have mildly abnormal TSH but only 1-2% a true underlying thyroid abnormality.

+ many with abnormal TFTs have no follow up of this anyway!

Ok #MedStudentTwitter so we've got the basics of endocrinology now.

Keep reading for how that helps us understand hormone test results ⬇️⬇️ When faced with endocrine results, we usually start with the EFFECTOR HORMONE – is this normal/abnormal? ✅❎

If abnormal, we then look to the 2ry controlling hormone – has this made an APPROPRIATE COMPENSATION?

Hormones are tightly regulated🔄

For most we use a “neuroendocrine” system:

- a control centre in 🧠 (hypothalamus & pituitary) which integrate feedback & send signals (⬇️⬆️) to the

- primary endocrine glands (e.g. thyroid) re. how much “effector hormone” to make "Tropic" hormones (e.g. corticotropin aka ACTH) signal to another endo gland.

"Effector" hormones have widespread targets throughout the body & usually affect processes e.g. growth, metabolism 👶👧👩‍🦰
They also ‘feed back’ on the control centre 🔄

This week we are going to cover some #Endocrinology topics for #medstudenttwitter.

Going to start with some fundamentals to get us going as grasping these basics really makes interpretation much easier! Endocrinology is about communication! 📞📢

Hormones are messengers that travel around the body to act in distant organs and tissues.

There are 2 main types of hormones. Knowing a little about this helps predict hormone behaviour:

So this weekend you heard from our friends @BukuRenal that mismanagement of IV fluids can cause harm.

A group we’d like to highlight who can come to serious harm from ⬆️/⬇️ fluids is patients with

💦DIABETES INSIPIDUS 💦

See below 👇

#medtwitter #FOAMed Diabetes insipidus (DI) is the inability to hold onto water due to lack of /resistance to ADH.

Remember ADH is released as serum osmolality ⬆️ to ⬆️ renal water reabsorption, but in patients with DI this doesn’t occur and so they pass large vol watery urine - can be >10L/day!🛁