Endocrinology Book

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Hyperthyroidism Management

Aka: Hyperthyroidism Management
  1. See Also
    1. Thyroid Storm
    2. Hyperthyroidism
    3. Grave's Disease
    4. Subclinical Hyperthyroidism
  2. Medications: Antiadrenergic Medications
    1. Indications
      1. Thyroiditis
      2. Concurrent initially with ablation, PTU/MTZ, surgery
      3. Symptomatic control
        1. Controls Tremor, Palpitations, nervousness
    2. Beta Blockers (non-selective preferred)
      1. Propranolol
        1. Start: 10-20 mg PO q6 hours
        2. Advance to 20 to 80 mg PO q6 hours
    3. Diltiazem (Cardizem)
      1. Alternative if Beta Blockers not tolerated
  3. Medications: Antithyroid Medications
    1. Indications
      1. Hyperthyroidism in children and adolescents
      2. Pregnancy (PTU)
      3. Severe Grave's Disease
    2. Antithyroid Medications
      1. Methimazole 15-30 mg per day
      2. Propylthiouracil (PTU) 100-200 mg PO tid
        1. Indicated in pregnancy
    3. Monitoring
      1. See Antithyroid Medications
  4. Management: Ablation
    1. Radioactive Iodine
      1. Management of choice for Grave's Disease of all ages
      2. Recurrent Hyperthyroidism after Antithyroid Drugs
      3. Toxic Multinodular Goiter
      4. Toxic Nodule in patient over age 40 years
    2. Subtotal Thyroidectomy
      1. Pregnancy
      2. Children intollerant to antithyroid medications
      3. Toxic Nodule under age 40 years
      4. Large ThyroidGoiter causing local compression
    3. Monitoring after ablation
      1. Thyroid Stimulating Hormone may not be accurate
      2. Follow Free T4, Free T3 to base Thyroid Replacement
  5. References
    1. Ginsberg (2003) CMAJ 168:575-85
    2. Reid (2005) Am Fam Physician 72:623-36

Hyperthyroidism (C0020550)

Definition (NCI) Overactivity of the thyroid gland resulting in overproduction of thyroid hormone and increased metabolic rate. Causes include diffuse hyperplasia of the thyroid gland (Graves' disease), single nodule in the thyroid gland, and thyroiditis. The symptoms are related to the increased metabolic rate and include weight loss, fatigue, heat intolerance, excessive sweating, diarrhea, tachycardia, insomnia, muscle weakness, and tremor.
Definition (NCI) A disorder characterized by excessive levels of thyroid hormone in the body. Common causes include an overactive thyroid gland or thyroid hormone overdose.
Definition (CSP) excessive functional activity of the thyroid gland.
Definition (MSH) Hypersecretion of THYROID HORMONES from the THYROID GLAND. Elevated levels of thyroid hormones increase BASAL METABOLIC RATE.
Definition (NCI) Too much thyroid hormone. Symptoms include weight loss, chest pain, cramps, diarrhea, and nervousness.
Concepts Disease or Syndrome (T047)
MSH D006980
ICD10 E05.9
SnomedCT 34486009, 154655004, 190239004, 267464006
English Hyperthyroidism, HYPERTHYROIDISM, Hyperthyroidism, NOS, overactive thyroid, hyperthyroidism, hyperthyroidism (diagnosis), Hyperthyroidism NOS, Hyperthyroidism [Disease/Finding], Primary Hyperthyroidism, Primary Hyperthyroidisms, Hyperthyroidism, Primary, hyperthyroidism nos, Hyperthyroidism (disorder), Overactive Thyroid
French HYPERTHYROIDIE, Hyperthyréose, Hyperthyroïdie, Hyperthyroïdisme
Spanish HIPERTIROIDISMO, Hyperthyroidism, hipertiroidismo (trastorno), hipertiroidismo, Hipertiroidismo
German HYPERTHYREOSE, Hyperthyroidismus, Hyperthyreoidismus, Hyperthyreose
Japanese 甲状腺機能亢進症, ｺｳｼﾞｮｳｾﾝｷﾉｳｺｳｼﾝｼｮｳ
Swedish Hypertyreos
Czech hypertyreoidismus, Hypertyreóza
Finnish Kilpirauhasen liikatoiminta
Russian GIPERTIREOIDIZM, GIPERTIREOZ, ГИПЕРТИРЕОЗ, ГИПЕРТИРЕОИДИЗМ
Portuguese HIPERTIROIDISMO, Hipertiroidismo, Hipertireoidismo
Croatian HIPERTIREOZA
Polish Nadczynność tarczycy
Hungarian Hyperthyreosis
Dutch hyperthyroïdie, Basedow, ziekte van, Hyperthyreose, Hyperthyreoïdie, Hyperthyroïdie, Thyreoïdie, hyper-
Italian Ipertiroidismo
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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