Excess thyroid hormone production (Graves, toxic nodular goitre, thyroiditis).
Clinical features
- • Weight loss, heat intolerance, sweating
- • Palpitations, tremor, anxiety
- • Diarrhoea, oligomenorrhoea
- • Lid lag, eye signs (Graves)
Investigations
- • TSH ↓, free T4/T3 ↑
- • TSH receptor antibody (Graves)
- • Radioiodine uptake scan (differentiate)
Management
- • Symptom: propranolol 40 mg q6h
- • Carbimazole 20–40 mg OD (block-replace or titration regimen)
- • Definitive: radioiodine or thyroidectomy
- • Graves: PTU preferred 1st trimester pregnancy
Complications
- • Thyroid storm
- • AF, heart failure
- • Osteoporosis
References
- • ATA Hyperthyroidism 2016
Related in WardRound
Educational — verify locally.
