Hyperthyroidism Flashcards
What is Hyperthyroidism?
Hyperthyroidism results from excessive production and secretion of thyroid hormones, leading to thyrotoxicosis (an excess of circulating thyroid hormones).
What is Thyrotoxicosis?
Thyrotoxicosis is the clinical manifestation of excess circulating thyroid hormones due to any cause, including hyperthyroidism. It can also occur without hyperthyroidism, such as in thyroiditis or excess levothyroxine intake.
What are the common signs and symptoms of Hyperthyroidism?
Signs and symptoms of Hyperthyroidism include:
Goitre (enlarged thyroid)
Hyperactivity, disturbed sleep
Fatigue, palpitations, anxiety
Heat intolerance, increased appetite, unintentional weight loss, and diarrhoea.
What are some complications of Hyperthyroidism?
Complications include:
Graves’ orbitopathy (bulging eyes, double vision)
Thyroid storm (life-threatening condition)
Pregnancy complications
Reduced bone mineral density
Heart failure and atrial fibrillation
What is the difference between overt and subclinical hyperthyroidism?
Overt hyperthyroidism: TSH levels are below the reference range, and FT4 and/or FT3 levels are above the reference range.
Subclinical hyperthyroidism: TSH is suppressed, but FT4 and FT3 are within the reference range.
What are some non-drug treatments for Hyperthyroidism?
Non-drug treatments include:
Radioactive iodine or surgery (e.g., total thyroidectomy or hemithyroidectomy) for conditions like Graves’ disease or toxic nodular goitre.
What is the recommended treatment for Graves’ disease?
Graves’ disease is treated with:
Radioactive iodine as first-line treatment (unless unsuitable).
Carbimazole (antithyroid drug) is used for 12-18 months, with either block and replace or titration regimens.
What should be done if agranulocytosis occurs during antithyroid drug treatment?
If agranulocytosis (a severe lack of neutrophils) occurs during treatment with antithyroid drugs like carbimazole, stop the medication immediately and do not restart.
What is Toxic nodular goitre?
Toxic nodular goitre is a condition where one or more nodules in an enlarged thyroid gland produce excessive thyroid hormone, leading to hyperthyroidism.
How is Toxic nodular goitre treated?
For Toxic nodular goitre, treatment options include:
Radioactive iodine as first-line treatment for multiple nodules.
Total thyroidectomy or hemithyroidectomy for single nodules.
If surgery or radioactive iodine is unsuitable, antithyroid drugs are used long-term.
What is the management of subclinical hyperthyroidism?
For subclinical hyperthyroidism:
Consider specialist advice if TSH is <0.1 mIU/L with symptoms of thyrotoxicosis.
Measure TSH every 6 months in untreated patients.
What is the approach for hyperthyroidism during pregnancy?
For hyperthyroidism in pregnancy:
Females planning pregnancy should seek endocrinology advice before conception and use effective contraception.
Pregnant women should be urgently referred to a specialist.
Avoid pregnancy for 6 months after radioactive iodine treatment.
What is the safety information regarding carbimazole in pregnancy?
Carbimazole has increased risk of congenital malformations, so stronger contraception is advised during its use. Pregnant females should seek medical advice if taking carbimazole.
