Hyperthyroidism

Last updated: Monday, 13, December, 2010
CausesAppropriate Tests

Thyroid stimulating hormone ( TSH ).
If TSH is suppressed: thyroxine (free) . If TSH is high or high normal, and there is a strong clinical suspicion of hyperthyroidism (ie, pituitary origin): thyroxine (free).
If thyroxine (free) is normal and there is a strong clinical suspicion of hyperthyroidism: triiodothyronine (free).

See also Hyperthyroxinaemia (euthyroid)

Radioactive isotope uptake studies (nuclear medicine).

Monitoring: TSH should be within the reference interval although this may take 2-3 months to achieve; thyroxine (free) may be useful in the early stages of treatment.

Patients with a history of thyroid disease should always have TSH performed prior to anaesthesia/surgery.

See also Goitre

Graves disease

TSH receptor antibodies are of limited value in monitoring treatment.

Toxic multinodular goitre

Toxic adenoma

Hashimoto disease

Thyroid antibodies.

Subacute thyroiditis

Thyroid antibodies.

Drug induced, especially

  • Amiodarone
  • Thyroxine
  • Interferon

 

Thyrotoxicosis factitia.

TSH overproduction, especially

  • Hypothalamic/pituitary tumour
  • Pituitary T4 resistance

 

See Pituitary hormone excess-thyrotrophin

Trophoblastic disease, including

Human chorionic gonadotrophin (beta subunit).