Last reviewed: June 2018
Last updated: January  2018

Summary

Definition

History and exam

Key diagnostic factors

  • heat intolerance
  • nervousness
  • small nontender goiter
  • tremulousness

Other diagnostic factors

  • palpitations
  • weight loss
  • excessive fatigue
  • bloating
  • muscle cramps
  • weight gain
  • poor concentration
  • cold intolerance
  • tachycardia

Risk factors

  • postpartum period
  • female sex
  • TPO (thyroid peroxidase) antibodies
  • cytokine therapy
  • biologic agent therapy
  • lithium therapy
  • type 1 diabetes and other autoimmune conditions
  • autoimmune FHx

Diagnostic investigations

1st investigations to order

  • thyroid-stimulating hormone (TSH)
  • serum free T4 and T3
  • TPO (thyroid peroxidase) antibodies
  • TSH-receptor antibodies (TRAb)
  • 4-, 6-, or 24-hour radioiodine uptake
  • total T3/T4 ratio
Full details

Investigations to consider

  • technetium-99m pertechnetate scan
  • serum thyroglobulin
  • thyroid biopsy
Full details

Emerging tests

  • color-flow Doppler
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Consultant

Department of Endocrinology

Newcastle upon Tyne Hospitals NHS Foundation Trust

Newcastle upon Tyne

UK

Disclosures

PP has been an invited speaker on thyroid topics for the British Endocrine Society, the European Congress of Endocrinology, the Hellenic Endocrine Society, the Caledonian Society of Endocrinology, and the American Association of Clinical Endocrinologists Gulf Chapter. He has received an honorarium for speaking at the American Association of Clinical Endocrinologists Gulf Chapter.

Dr Petros Perros would like to gratefully acknowledge Dr Douglas S. Ross, the previous contributor to this monograph. DSR declares that he has no competing interests.

Peer reviewers VIEW ALL

Centre for Endocrine and Diabetes Sciences

Cardiff University School of Medicine

University Hospital of Wales

Heath Park

Cardiff

UK

Disclosures

JL 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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