Thyroid Physiology

Causes

Primary Thyrotoxicosis

Grave’s Disease → TSI

Thyroid Toxic adenoma → Thyroid US

Multinodular Goitre → Thyroid US

Subacute Thyroiditis → RAIU

Pregnancy-related Hyperthyroidism - b-HCG

L-thyroxine - history

Secondary Thyrotoxicosis - Rare

Anterior Pituitary Diseases

Tertiary Thyrotoxicosis

Hypothalamic Disease

Common Presentation

Symptoms

• Hyper-metabolism
  • Heat intolerance
  • Weight loss despite good nutrient intake (can have increased appetite)
• Over-activity of adrenal system
  • Symptom resembling Pheochromocytoma↑
• Oligo-amenorrhea (TSH → PCOS)
• Increased bowl movement (Diarrhea)
• Soft and moist skin, Silky hair, hair loss
• Perspiration/Diaphoresis
• May assoc. with congestive HF - Heart Failure
  • Easy Fatigue , SOB, syncope, chest discomfort

Common Physical Exam Findings

• Physical Signs of Hyperthyroidism
• Grave’s Disease Specific Signs