Hyperthyroidism

Does the thyroid make you anxious?

Hyperthyroidism typically presents with:

• Heat intolerance

• Tremors

• Palpitations

• Anxiety

• Weight loss

Notably, it may predispose a patient to:

• Osteoporosis

• Anemia

• Atrial fibrillation

• Muscle weakness/atrophy

Here is a flow-chart you can use to think about the differential diagnosis of hyperthyroidism and the management associated with each condition.

Treatment options:

1. Antithyroid drugs are reserved for those with mild hyperthyroidism, patients with older age, or those who are pregnant.

   1. PTU is preferred in the 1^st trimester while methimazole is used in the 2^nd and 3^rd!

2. Radioactive iodine is used for those with moderate-severe hyperthyroidism.

3. Indications for thyroidectomy include large goiter, concern for neoplasia, coexisting hyperparathyroidism, severe ophthalmopathy.

All information is adopted from UWorld and UpToDate.