Hyperthyroidism is over activity of the thyroid gland, which results in a number of symptoms and signs. It’s causes can be related to a primary or secondary diagnosis:
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NB: although these symptoms may be present, the symptoms and signs can be variable and in some patients they are very mild.
Thyrotoxic periodic paralysis is a serious complication characterised by muscle paralysis and hypokalaemia due to a massive intracellular shift of potassium. An annual incidence of up to 2% has been reported in Asian people with thyrotoxicosis.
After TSH has normalised with normal FT4 and FT3 and reducing medication accordingly, continue monitoring Thyroid-stimulating Hormone (TSH) 3 monthly for at least 12 months.
In Graves Disease repeat TRAb test at 12-18 months as low levels at this point indicate a low risk of relapse and medication can be stopped. If TRAb levels continue to be very elevated then refer to secondary care for consideration of Definitive Therapy.
Repeat Thyroid-stimulating Hormone (TSH) annually thereafter as there is a risk of relapse.
For further prescribing information please see the Gloucestershire Joint Formulary information on thyroid and anti-thyroid drugs.
Consider either Advice & Guidance or referral to Endocrinology if any of the following are present: