Let's go on to a case.
A 38 year old woman comes to see you
complaining of insomnia, frequent stools,
anxiety, hair loss and muscle weakness
in her upper and lower extremities.
On exam, her heart rate is at 110
beats per minute and you note
that her eyes appear to bulge with
visible sclera above and below her iris.
What would her thyroid labs show?
So clinically, this patient is manifesting siginficant
symptoms and signs of thyroid hormone excess.
Firstly, the frequent stools, the anxiety
and the hair loss, muscle weakness,
when put together really suggests that
she has an excess of thyroid hormone.
When you examine the patient, she is
tachycardic, she has an elevated heart rate
and her eyes appear to bulge with
sclera visible above the iris,
this is a hallmark of what we
call "Dysthyroid eye disease".
Where the effect of excessive thyroid
hormone on the eye's most prominent.
Patients have proptosis which is the appearance
where the eye appears to bulge in the orbit
and the lid of the eye is retracted, such that
you're able to see the sclera above the iris.
The conclusion of this case is that
the patient's clinical presentation
is significant for most
likely, Graves' disease.
We can confirm this diagnosis
by checking some labs.
Her TSH will be low, and T4
and/or T3 will be elevated,
which is the classic hallmark
or pattern in hyperthyroidism.