title: Evaluating and managing patients with thyrotoxicosis.
abstract: BACKGROUND
  Thyrotoxicosis is common in the Australian community and is frequently encountered in general practice. Graves disease, toxic multinodular goitre, toxic adenoma and thyroiditis account for most presentations of thyrotoxicosis.
  
  
  OBJECTIVE
  This article outlines the clinical presentation and evaluation of a patient with thyrotoxicosis. Management of Graves disease, the most frequent cause of thyrotoxicosis, is discussed in further detail.
  
  
  CONCLUSIONS
  The classic clinical manifestations of thyrotoxicosis are often easily recognised by general practitioners. However, the presenting symptoms of thyrotoxicosis are varied, with atypical presentations common in the elderly. Following biochemical confirmation of thyrotoxicosis, a radionuclide thyroid scan is the most useful investigation in diagnosing the underlying cause. The selection of treatment differs according to the cause of thyrotoxicosis and the wishes of the individual patient. The preferred treatment for Graves disease is usually antithyroid drug therapy, almost always carbimazole. The primary treatment of a toxic multinodular goitre or toxic adenoma is usually radioactive iodine therapy. Specific therapy is usually not warranted in cases of thyroiditis, however, treatment directed at symptoms may be required. Referral to an endocrinologist is recommended if thyroiditis is unlikely or has been excluded.
authors.affiliation: Department of Endocrinology, The Queen Elizabeth Hospital, Adelaide, South Australia. kirsten.campbell@health.sa.gov.au
authors.forename: Kirsten
authors.initials: K
authors.lastname: Campbell
authors.forename: Matthew
authors.initials: M
authors.lastname: Doogue
mesh_terms: D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use; D002231:Carbimazole / Q000627:therapeutic use; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D013965:Thyroidectomy; D013971:Thyrotoxicosis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*
chemical_list: D013956:Antithyroid Agents; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D002231:Carbimazole