ABSTRACT
This chapter examines what is required in terms of competencies, skills and knowledge from junior physicians in core medical training in endocrine and diabetes. Thyroid hormones contain iodine. Terrestrial vertebrates do not get much, so the thyroid is adapted to trap it. Iodine deficiency causes thyroid hypertrophy and goitre. Graves' disease is the most common cause of thyrotoxicosis in pregnancy. It is also recognised that activation of the thyroid-stimulating hormone (TSH) receptor by BHCG may also occur – often termed transient gestational hyperthyroidism. Despite stopping the amiodarone, thyrotoxicosis may persist for many months and so additional treatment is often required. Hashimoto's thyroiditis is an autoimmune disorder of the thyroid gland. It is typically associated with hypothyroidism although there may be a transient thyrotoxicosis in the acute phase. In pregnancy, there is an increase in the levels of thyroxine-binding globulin (TBG). This causes an increase in the levels of total thyroxine but does not affect the free thyroxine level.
