From the Guidelines
Thyrotoxicosis is characterized by ten key clinical features, including weight loss, palpitations, heat intolerance, tremors, anxiety, diarrhea, and other symptoms of hypermetabolic activity, as a result of excessive thyroid hormone in the body. These clinical characteristics can be enumerated as follows:
- Weight loss despite normal or increased appetite
- Palpitations and tachycardia (rapid heart rate)
- Heat intolerance with increased sweating
- Tremors, particularly fine tremors of the outstretched hands
- Anxiety and emotional lability
- Diarrhea or hyperdefecation
- Muscle weakness and fatigue
- Menstrual irregularities in women
- Exophthalmos (bulging eyes, especially in Graves' disease)
- Goiter (enlarged thyroid gland), as noted in patients with Graves’ disease 1. These symptoms occur because thyroid hormones increase metabolic rate throughout the body, affecting virtually every organ system, and can be managed conservatively during the thyrotoxic phase of thyroiditis, with non-selective beta blockers and thyroid hormone replacement initiated at the time of hypothyroidism diagnosis 1.
From the Research
Clinical Characteristics of Thyrotoxicosis
The following are 10 clinical characteristics of thyrotoxicosis:
- Anxiety 2
- Insomnia 2
- Palpitations 2
- Unintentional weight loss 2
- Diarrhea 2
- Heat intolerance 2
- Diffusely enlarged thyroid gland (in patients with Graves' disease) 2
- Stare or exophthalmos (in patients with Graves' disease) 2
- Dysphagia, orthopnea, or voice changes (in patients with toxic nodules) 2
- Cardiac arrhythmias and heart failure (in untreated cases) 2
Causes and Treatment
Thyrotoxicosis can be caused by various conditions, including Graves' disease, toxic multinodular goiter, toxic adenoma, and subacute thyroiditis 3, 2, 4. Treatment options depend on the underlying cause and may include medications (e.g., antithyroid drugs, beta-blockers), radioactive iodine therapy, or surgical removal of the thyroid gland (thyroidectomy) 3, 2, 4.
Diagnosis and Management
Diagnosis of thyrotoxicosis is typically established based on clinical presentation, thyroid function tests, and thyrotropin-receptor antibody status 2. Thyroid scintigraphy is recommended if thyroid nodules are present or the etiology is unclear 2. Management of thyrotoxicosis involves treating the underlying cause and may include supportive care, antithyroid drugs, radioactive iodine ablation, or surgery 2, 5.