Hyperthyroidism

Clinical Manifestation: fatigue, weight loss, heat intolerance, depression nervousness, irritability, anxiety or agitation, menstrual irregularities, weakness or tremors, palpitations, exertional dyspnea, hyperdefecation, anterior neck pain, insomnia

Etiology: 

 • Primary Causes: Toxic multinodular goiter, Toxic uninodular goiter, Toxic diffuse goiter ( Graves' disease), Thyrotoxicosis associated with thyroiditis

 • Secondary Causes: Factitious thyrotoxicosis, T3 Toxicosis, iodine loads, Metastatic Follicular CA, malignancies with circulating thyroid stimulators, TSH- producing pituitary tumors, Struma Ovarii with hyperthyroidism

Diagnosis:

 • Low TSH with elevated T3 and T4

 • Thyroid scintigraphy with radioactive iodine uptake

 • Thyroid stimulating immunoglobulin (TSI) or Thyrotropin (TSH) receptor antibodies (TRAb) if Graves' disease is suspected

Treatment:

 • Beta blockers

 • Thiomides ( Methimazole and PTU)

 • Radioactive iodine therapy

 • Thyroidectomy



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