Peer Reviewed
Feature Article Endocrinology and metabolism
A guide to thyroid dysfunction
Abstract
Thyroid dysfunction is common but can present both diagnostic and management challenges. This article will present a practical approach to patients with hyperthyroidism and hypothyroidism.
Key Points
- Thyroid dysfunction is common in the community. The prevalence of hyperthyroidism is approximately 1 to 2% and hypothyroidism 5 to 10%, with a strong female predominance.
- Graves’ disease is the most common cause of hyperthyroidism. Other causes include a toxic multinodular goitre, toxic adenoma and thyroiditis.
- A technetium-99m nuclear thyroid uptake scan and measurement of thyroid receptor antibodies are the most useful initial investigations for determining the cause of hyperthyroidism, if it is not clinically apparent.
- Treatment of hyperthyroidism usually involves antithyroid drugs (carbimazole or propylthiouracil), radioactive iodine or total thyroidectomy.
- The presence of autoimmune thyroid disease (Hashimoto’s thyroiditis), which is the most common cause of hypothyroidism, is confirmed by the presence of antithyroglobulin and/or antimicrosomal (antithyroid peroxidase) antibodies.
- Careful up-titration of thyroxine dose is usually required in treatment of hypothyroidism.
- Thyroid dysfunction in pregnancy is an important clinical scenario and requires specialist involvement.
- Treatment of subclinical thyroid dysfunction is controversial.
Get full access
Buy this article
Single article purchases are temporarily unavailable due to site maintenance.
If you would like to purchase an article during this time, please email us at [email protected] with the article details and we'll assist you directly. We'll also let you know when online purchasing is available again.
Thank you for your patience and understanding.
Already a subscriber? Login here.