title: 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis.
abstract: Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This document describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspecialty physicians and others providing care for patients with this condition.
  
  
  
  The American Thyroid Association (ATA) previously cosponsored guidelines for the management of thyrotoxicosis that were published in 2011. Considerable new literature has been published since then, and the ATA felt updated evidence-based guidelines were needed. The association assembled a task force of expert clinicians who authored this report. They examined relevant literature using a systematic PubMed search supplemented with additional published materials. An evidence-based medicine approach that incorporated the knowledge and experience of the panel was used to update the 2011 text and recommendations. The strength of the recommendations and the quality of evidence supporting them were rated according to the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation Group.
  
  
  
  Clinical topics addressed include the initial evaluation and management of thyrotoxicosis; management of Graves' hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery; management of toxic multinodular goiter or toxic adenoma using radioactive iodine or surgery; Graves' disease in children, adolescents, or pregnant patients; subclinical hyperthyroidism; hyperthyroidism in patients with Graves' orbitopathy; and management of other miscellaneous causes of thyrotoxicosis. New paradigms since publication of the 2011 guidelines are presented for the evaluation of the etiology of thyrotoxicosis, the management of Graves' hyperthyroidism with antithyroid drugs, the management of pregnant hyperthyroid patients, and the preparation of patients for thyroid surgery. The sections on less common causes of thyrotoxicosis have been expanded.
  
  
  
  One hundred twenty-four evidence-based recommendations were developed to aid in the care of patients with thyrotoxicosis and to share what the task force believes is current, rational, and optimal medical practice.
authors: 1 Massachusetts General Hospital , Boston, Massachusetts.
authors: Douglas S
authors: DS
authors: Ross
authors: 2 Endocrinology - Metabolic Service, Walter Reed National Military Medical Center , Bethesda, Maryland.
authors: Henry B
authors: HB
authors: Burch
authors: 3 Division of Endocrinology, Diabetes, and Metabolism, The Johns Hopkins University School of Medicine , Baltimore, Maryland.
authors: David S
authors: DS
authors: Cooper
authors: 4 Western Slope Endocrinology , Grand Junction, Colorado.
authors: M Carol
authors: MC
authors: Greenlee
authors: 5 Departments of Clinical Medicine and Endocrinology, Aalborg University and Aalborg University Hospital , Aalborg, Denmark .
authors: Peter
authors: P
authors: Laurberg
authors: 6 Thyroid Section, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul , Porto Alegre, Brazil .
authors: Ana Luiza
authors: AL
authors: Maia
authors: 7 Pediatrics - Chairman's Office, University of Florida College of Medicine , Gainesville, Florida.
authors: Scott A
authors: SA
authors: Rivkees
authors: 8 Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health & Science University , Portland, Oregon.
authors: Mary
authors: M
authors: Samuels
authors: 9 Section of Endocrine Surgery, Duke University School of Medicine , Durham, North Carolina.
authors: Julie Ann
authors: JA
authors: Sosa
authors: 10 Division of Endocrinology, Mayo Clinic , Rochester, Minnesota.
authors: Marius N
authors: MN
authors: Stan
authors: 11 Institute of Nuclear Medicine, University Hospital Bern , Switzerland .
authors: Martin A
authors: MA
authors: Walter
mesh_terms: D003131:Combined Modality Therapy / Q000009:adverse effects; D019317:Evidence-Based Medicine; D006801:Humans; D006980:Hyperthyroidism / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D057285:Precision Medicine; D012720:Severity of Illness Index; D012955:Societies, Medical; D013971:Thyrotoxicosis / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D014481:United States