Content and Tone Evaluation

• Is everything in the article relevant to the article topic? Is there anything that distracted you?
• Is any information out of date? Is anything missing that could be added?

• What else could be improved?
• Is the article neutral? Are there any claims that appear heavily biased toward a particular position?
• Are there viewpoints that are over-represented, or underrepresented?

The article provided an elaborate description about endocrine disruptors, which are responsible for some hormonal dysfunctions. The history section informs the reader of the identification of these chemicals, the importance of knowing what they do, and draws the readers attention in a neutral tone by indicating the various view on endocrine disruptors.

The section regarding "Effects on levels of the body's own hormones," needs more information and clarification. The first sentence is not well structured; it is a run on and needs punctuation.

The section talking about the types of chemicals does not provide detailed information about the various hormones the chemicals mimic and the organs they affect.

There are few grammatical corrections that need to be made.

Source Evaluation

The article uses secondary citation that provides support for the article.

Some primary articles were used and which does not show a collective view on the section discussing Bisphenol A.

Talk Page

This article is rated as C-Class. It's a part of the medicine WikiProject.

The conversations on the talk page, are mostly discussing categorizing the various types of endocrine disruptors as well as evaluation of the sources.

• Thyroid Disease

Since the thyroid gland is responsible for metabolic activities, and it's hormones a major contributor growth and development, I will like to create a section in this article to write about the various diseases affect growth and development.

• Endocrine disruptor

• Bisphenol A (Health effects)

In the health effects section, there isn't much information about the various implications of BPA in detail. Thus, I would like to improve this section by expanding some health effects and pathways on bone metabolism, and reproductive health.

Sources:

1. https://www.ncbi.nlm.nih.gov/pubmed/25813067
2. https://www.ncbi.nlm.nih.gov/pubmed/29432759
3. https://www.intechopen.com/books/bisphenol-a-exposure-and-health-risks/the-ovary-as-a-target-organ-for-bisphenol-a-toxicity
4. https://www.intechopen.com/books/bisphenol-a-exposure-and-health-risks/the-toxic-effects-bpa-on-fetuses-infants-and-children
5. https://www.ncbi.nlm.nih.gov/pubmed/29925041

• Behavioral Endocrinology

Thyroid hormones are responsible for controlling metabolism, nervous system, body temperature and development of several organ systems such as the reproductive system. The overproduction and under secretion of the thyroid hormones changes the function of the thyroid. Hyperthyroidism and hypothyroidism are the two major dysfunctions associated to behavioral and brain chemistry changes due to the imbalances in the thyroid hormones, triiodothyronine (T₃) and thyroxine (T₄) ^[1].

thyroxine (T4) and triiodothyronine (T3) are the main hormones released in the thyroid gland. They are synthesized from tyrosine and iodine in the bloodstream. These hormones travel via the bloodstream to almost every cell throughout the body and function to regulate their target cell's metabolism. These hormones are a product of the hypothalamic–pituitary–adrenal axis (HPA axis or HTPA axis). These organs function together as the hypothalamus releases thyrotropin-releasing hormone (TRH), which cause the pituitary gland to secrete thyrotropin that signals the thyroid gland to process and release thyroxine and triiodothyronine to the body. These hormones play a major role in the Neuroendocrine system which regulates the vital body functions of breathing, body weight, heart rate, muscle strength, cholesterol levels, especially body temperature. When your body has too much or too little of these hormones it has abnormal effect throughout your body:

The overproduction of thyroxine and triiodothyronine result in hyperthyroidism which increases metabolic activity. In Grave's disease, an autoimmune condition which is another cause of hyperthyroidism, excessive production of hormones occur due to the production of antibodies that stimulate the thyroid gland^[2]. Exophthalmos, bulging of the eyes, is quite prominent in Grave's disease. There are other medical conditions like goiter, visible swelling of the thyroid gland, that can also lead to this dysfunction^[3]. Thyroiditis, the inflammation of the thyroid, also contributes to thyrotoxicosis. The overactive activity of the thyroid induces these symptoms of Hyperthyroidism:

• Anxiety
• Irritability or moodiness
• Hyperactivity and nervousness
• Excessive sweating and sensitivity to higher temperatures
• Hand Trembling
• Missed or light menstrual periods
• weight loss
• Itching and dryness of skin
• difficulty in sleeping

Hyperthyroidism occurs more in women than in men. Due to the genetic factors associated with the dysfunction, it has the propensity to run in families.

Thyrotoxicosis does not exacerbate during pregnancy and about 1 percent of women experience thyroid dysfunction in pregnancy. Hyperthyroidism constitutes to various effects during pregnancy. Hyperthyroidism has been shown to induce high blood pressure in pregnant women. Among that, it could also lead to premature birth, where the baby is born in fewer weeks than the 37 weeks' gestational period, and is at risk of dying and having several disabilities due to low birth weight. Also alarmingly high levels of thyroid hormones causes thyroid storm, a life-threatening form of hyperthyroidism^[4].

The methods presently used for detecting hyperthyroidism are blood-test and physical examination.

• Thyroid-stimulating hormone (TSH) concentrations along with the thyroid hormones T3 and T4 are measured from biological samples. Increased levels of thyroid hormone thyroxine (FT4), with low levels of thyroid-stimulating hormone in blood plasma by immunometric assays of an individual is a common indicator of an overactive thyroid gland^[5].
• The analysis of an ultrasound and nuclear scans of the thyroid provides a clear image of the thyroid to identify if there are nodules present. Enlarged or inflamed thyroid indicate an overactive thyroid.
• The measurement of thyroid-stimulating hormone receptor antibodies, is an important diagnostic tool to know whether over activity is associated to Graves' disease^[6]. Individuals with the autoimmune disorder thyroiditis show high levels of antibodies, thus increased amount thyroid stimulating immunoglobulins constitutes to hyperthyroidism.

Treatment of hyperthyroidism pertains to each individual due to the consideration of factors like age, medical conditions, and type of hyperthyroidism.

• Antithyroid medication:

Antithyroid drugs that affect the production of thyroid hormones is the preferred choice for treating pregnant women and children. Drugs such as methimazole or tapazole and propylthiouracil serve as antagonist on the receptors of the thyroid glands reducing its production of thyroid hormones^[7]. Propylthiouracil is predominantly used for pregnant women in their first trimester of pregnancy. The use of methimazole has been associated with birth defects. The length of treatment depends on the severity of the hyperthyroidism.

Include side effects of medication?

• Surgical procedure:

Another treatment of hyperthyroidism is the removal of the thyroid gland. Prior to surgical removal of the thyroid gland, patients with persistent over-activity are treated with antithyroid drugs. Removal of the thyroid gland could potentially lead to hypothyroidism, hence patients will be required to take thyroid hormone agonists such as levothyroxine^[7].

• Radioactive iodine:

Radioactive iodine (RAI) therapy is one of the safest treatment for hyperthyroidism with little to no potential side effects. For decades radioactive iodine therapy has been used to patients over 60 years due to its low risk rate. The process involves the eradication of the thyroid cells that obtain iodine from the bloodstream needed for the synthesis of thyroid hormones. Radioactive iodine capsules are given to patients and taken orally. Once ingested the radioactive iodine flows through the bloodstream to target the thyroid cell that are overactive. The radioactive iodine causes the thyroid nodules to reduce in size, in turn restoring thyroid hormone levels^[8]. Women that have undergone radioactive iodine treatment, and desire to get pregnant are required to wait for a year after therapy.

• Use of Beta blockers:

Beta blocker are prescribed to patients regardless of the treatments listed above. They help alleviate the symptoms of hyperthyroidism before any of the treatments are given based on the type of hyperthyroidism^[2].

Ignore the text below, not included in first draft.