Hyperthyroidism and Thyrotoxicosis

Abstract

Thyrotoxicosis is a term for excess thyroid hormone action. Hyperthyroidism is when thyroid is producing and releasing excess hormones. The most common cause is Graves’ hyperthyroidism, the next being toxic nodular goiter (Plummer’s disease). There are also several rare causes of overproduction of thyroid hormones. In conditions when destructive process in the thyroid results in release of stored hormones, the process is usually transient, and only symptomatic therapy is needed. For hyperthyroid overproduction category, either an 18-month course of antithyroid medication or ablative therapies such as surgery and radioactive iodine are needed. Long-term antithyroid therapy as an option for some patients with Graves’ disease has been recently recommended by ATA guidelines. Periodic TRAB (thyrotropin receptor antibodies) measurement during antithyroid therapy can be used as a guide for prediction of remission. Management of hyperthyroid and thyrotoxicosis syndromes should be tailored to the cause, associated with autoimmune manifestations, age of the patient, and other clinical considerations and patient preferences.