Maria was tired of not feeling like herself and tired of being so stressed about

Maria was tired of not feeling like herself and tired of being so stressed about it. She was particularly tired of how her eyes seemed to bulge outward, so much that her friend, Matt, had started calling her “Bug Eyes.”
Dr. Jollo looked at Maria and said “Well, your blood pressure and pulse are elevated. You’ve lost weight without trying, you have difficulty sleeping, you perspire more than usual and you’ve had continuing bouts of diarrhea. Those things, combined with the swelling in the front of your neck, suggest that you may be suffering from more than the stress of college life. I think we need to run some blood tests to check your thyroid function.”
Maria blinked in surprise. “All of those things can be caused by a problem with my thyroid? Even the way my eyes look?”
Dr. Jollo nodded. “Your thyroid secretes several hormones that have widespread and varied effects. The protrusion of your eyes is a condition called exophthalmos – it is an inflammatory response to abnormal levels of thyroid hormones. The fact that you have this condition in addition to your other symptoms makes me fairly certain this is a thyroid problem.”
Maria hoped Dr. Jollo was right. Having a medical explanation for her symptoms would mean that she wasn’t losing her mind.
Several days later, Maria met again with Dr. Jollo.
“Let’s talk about your test results,” he said. “Your thyroid hormone levels are elevated, but your level of thyroid-stimulating hormone (TSH) is lower than it should be. Those results suggest that you probably have Graves’ disease, which means that your thyroid is overactive. But there’s good news too—this is a condition that we can treat relatively easily.”
Maria felt a twinge of relief at the doctor’s words, but a flurry of questions poured out of her mouth. “What made my thyroid go crazy? And what is TSH? If it’s a thyroid hormone, why is it low instead of high like everything else? And what kind of treatment do I need? Will it fix my thyroid? Will I…”
Dr. Jollo laughed and held up his hand to stop the barrage of questions. “Hold on, Maria. I’ll explain everything, and with the right treatment, your friend may not be able to call you ‘Bug Eyes’ much longer.”

Questions
1. Name the two hormones commonly referred to as “thyroid hormone” and describe their general actions.
2. Why would an overactive thyroid cause Maria’s weight loss, sweating, and elevated heart rate?
3. Maria wonders if TSH is a “thyroid hormone,” and Dr. Jollo explains that it is not. State the action of thyroid-stimulating hormone (TSH) and name the gland that secretes it.
4. How is the secretion of TSH regulated under normal conditions?
5. Why is Maria’s TSH level low instead of high?
6. If Maria had been diagnosed with hypothyroidism, what would happen to her levels of TSH and thyroid hormone?
7. A common treatment for Graves’ disease involves ingesting a dose of radioactive iodine, which slowly destroys the thyroid gland. Why are other tissues unaffected?

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