Hyperthyroidism – Symptomatic


Pursue iCPI

  • In the hyperthyroid phase, patients may benefit from beta blockers if symptomatic (e.g., atenolol 25-50 mg daily, titrate for HR < 90 if BP allows). Monitor closely with regular symptom evaluation and fT4 testing every 2 weeks
  • Introduce thyroid hormones (see hypothyroidism management) if the patient becomes hypothyroid (low T4/T3, even if TSH is not elevated)

Assessment and Investigations

  • Thyroid function tests (fT3, fT4, TSH)
  • Anti-TPO, TSI
  • Thyroid echography (nodule?)
  • Medication history: amiodarone or lithium therapy
  • Suspect Graves’ disease if :
    – pretreatment by anti-CTLA-4
    – persistant hyperthyroidism beyond 6 weeks