Last reviewed: 19 Dec 2020
Last updated: 20 Sep 2019
Summary
Definition
History and exam
Other diagnostic factors
- heat intolerance, hyperphagia, or weight loss
- depression
- nervousness or palpitations
- oligomenorrhea
- hyperdefecation
- stare or lid lag
- warm, moist skin
- tachycardia
- irregular pulse
- tremor
- muscle weakness
- shortness of breath or choking sensation
- Pemberton sign
Risk factors
- iodine deficiency
- age >40 years
- head and neck irradiation
- family history of thyroid nodules
- female sex
Diagnostic investigations
Investigations to consider
- free T4 (or total T4 with a measure of binding)
- total T3 with a measure of binding (or free T3)
- I-123 thyroid scan and uptake
- Tc-99 pertechnetate scan
- thyroid ultrasound
- metabolic panel
- CBC
- thyroid peroxidase antibodies
- TSH receptor antibodies
- ECG
- CT neck (noncontrast)
Treatment algorithm
Contributors
Authors
Professor of Medicine
Boston University Medical Center
Boston
MA
Disclosures
ENP is the 2018-2019 President of the American Thyroid Association. She is an author of a number of references cited in this topic.
Dr Elizabeth N. Pearce would like to gratefully acknowledge Dr Sheila Feit, a previous contributor to this topic. SF was previously employed by BMJ.
Peer reviewers
Consultant Endocrinologist
Freeman Hospital
Newcastle-Upon-Tyne
UK
Disclosures
PP declares that he has no competing interests.
Professor of Surgery
Virginia Commonwealth University
Richmond
VA
Disclosures
RM declares that he has no competing interests.
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