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● Most cases result from Graves' (Basedow's) disease and thyroid gland autonomy, with the latter one predominating in areas of endemic goiter and frequently manifesting upon commencement with amiodarone therapy.
● Beta blockers are indicated in patients with heart rates >90 or with cardiovascular comorbidities. Following the determination of the complete blood count, bilirubin, and liver transaminanses, methimazole (propylthiouracil in pregnancy) is given for several weeks to achieve euthyreosis prior to causative treatment. Due to the risk of allergy, agranulocytosis, and hepatotoxicity, thyreostatic-treated patients should report any skin rash, fever, sore throat, and jaundice.
● Causative treatments comprise surgery and radioiodine therapy, depending on iodine uptake, comorbidities and patient's preferences. Thyreostatics can be used curatively for 12-18 months in Graves' disease upon complete blood count, and transaminase monitoring. All causative treatments may result in hypothyreosis.
● Subclinical hyperthyreoidism (normal free thyroxine) should be treated if TSH <0.1 mIU/L is accompanied by hyperthyroidism symptoms, age >65 years, cardiac disease, or osteoporosis. ≣