**5. Thyroid carcinoma**

skin, and constipation along with dyslipidemia. Hyperthyroidism produces weight loss, tremors, irritability, and hyperreflexia. Glucose intolerance can also be caused by hyperthyroidism. Thyroid hormone acts through T3 with nuclear receptors and regulation of gene expression. Hormone deficiency can cause retarded brain maturation and neurological impairment. Thyroid hormone deficiency is caused by congenital and maternal hypothyroidism. Hypothyroidism causes lethargy, hyporeflexia, poor motor coordination, and memory impairment. Hypothyroidism is also associated to bipolar affective disorders, depression, or loss of cognitive functions, especially in the elderly. Thyroid hormone deficiency, even of

There is suggestion that reduction in circulating thyroid hormone concentrations is one of the factors mediating impaired neurological development in intrauterine growth retardation and premature babies. More research is required to resolve these questions and ultimately shows if thyroid hormone or iodide supplementation in hypothyroid mothers in the antenatal period and in premature neonates can reduce the prevalence of neurodevelopmental delay.

Hyperthyroidism, which is usually due to autoimmune thyroiditis, clinically presents with tachycardia, increased systolic BP, weight loss in spite of increased appetite, and tremors in both hands. The cardiovascular system reveals fast pulse and sometimes irregular pulse known as auricular fibrillation. Auscultation of chest reveals systolic murmur. Neurological examination reveals brisk knee jerk, and patients show anxiety. There is history of diarrhea. In thyrotoxicosis, bone resorption leads to hypercalcemia. There is decreased PTH, decreased urinary, and fecal calcium excretion. There is hyperphosphatemia. Bone mineral density is decreased due to

In hypothyroidism, patient has a puffy and pallor look. Skin is dry, BP may be increased, and tongue is bigger and voice is hoarse and has constipation due to poor bowel moments. In hypothyroidism, PTH and vitamin D are increased due to low urinary calcium excretion. Decreased bone resorption and formation occurs. Serum osteocalcin and alkaline phospha-

Skeletal growth is influenced by thyroid hormone and growth hormone. In thyroid deficiency, there is decreased skeletal growth due to decreased growth hormone and insulin growth factor. Osteoblastic activity is decreased. In childhood thyrotoxicosis, there is advanced bone age

short duration, may lead to irreversible brain damage.

**2. Hyperthyroidism**

2 Thyroid Disorders

**3. Hypothyroidism**

osteoporosis. Forearms are more affected.

tase are decreased. Bone turnover is also decreased.

**4. Effect of thyroid disorders on bone**

due to premature fusion of epiphysis.

Thyroid carcinoma like anaplastic, follicular, and adeno may eventually cause hypothyroidism. Diabetes mellitus is associated more with hypothyroidism. In Grave's disease, eyes are involved which is termed as thyroid ophthalmopathy.

Thyroid diseases affect both mother and child before and after delivery. Untreated thyroid dysfunctions can affect neurointellectual development of fetus.
