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
- SOB or choking sensation
- Pemberton sign
Risk factors
- iodine deficiency
- age >40 years
- head and neck irradiation
- FHx thyroid nodules
- female gender
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 VIEW ALL
Associate Professor of Medicine
Boston University Medical Center
Boston
MA
Disclosures
ENP has received honoraria and travel funding for speaking at two international conferences for Merck Serono and at one for IBSA. She is a member of the Management Council of the Iodine Global Network. She is an author of a number of references cited in this monograph.
Dr Elizabeth N. Pearce would like to gratefully acknowledge Dr Sheila Feit, a previous contributor to this monograph. SF is an employee of the BMJ Group.
Peer reviewers VIEW ALL
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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