Abstract
Several studies have shown an increased risk for cardiovascular disease in hyperthyroidism, both at diagnosis and during long-term follow-up. The risk is highest for atrial fibrillation (AF) and arterial embolism. Clinical conditions at the diagnosis are variable, and the treatment (antithyroid drugs, surgery, or radioactive iodine) should be tailored in overt hyperthyroidism according to clinical presentation and thyroid physical examination. Thyrotoxic storm is a severe complication of hyperthyroidism, and its grading scale should be evaluated by Burch and Wartofsky score. Subclinical hyperthyroidism (SH) is a very frequent condition in which TSH levels are suppressed, whereas FT3 and FT4 are normal. SH is associated with an increase of cardiovascular risk for heart failure and AF and may increase the risk of fracture in osteoporotic women.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Bibliography
Dekkers OM, et al. Acute cardiovascular events and all-cause mortality in patients with hyperthyroidism: a population-based cohort study. Eur J Endocrinol. 2017;176(1):1–9.
Ross DS, et al. American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016;26(10):1343–421. https://doi.org/10.1089/thy.2016.0229.
Tibaldi JM, et al. Thyrotoxicosis in the very old. Am J Med. 1986;81:619–22.
Davis PJ, Davis FB. Hyperthyroidism in patients over the age of 60 years. Clinical features in 85 patients. Medicine (Baltimore). 1986;53:161–81.
Laurberg P, et al. High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves’ disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland Denmark and Iceland. J Intern Med. 1991;229:415–20.
Abraham-Nordling M. Incidence of hyperthyroidism in Sweden. Eur J Endocrinol. 2011;165:899–905.
Codaccioni JL, et al. Lasting remissions in patients treated for Graves’ hyperthyroidism with propranolol alone: a pattern of spontaneous evolution of the disease. J Clin Endocrinol Metab. 1988;67:656–62.
De los Santos ET, Starich GH, Mazzaferri EL. Sensitivity, specificity, and cost-effectiveness of the sensitive thyrotropin assay in the diagnosis of thyroid disease in ambulatory patients. Arch Intern Med. 1989;149:526–32.
Klein I, Becker DV, Levey GS. Treatment of hyperthyroid disease. Ann Intern Med. 1994;121:281–8.
Burch HB, Burman KD, Cooper DS. A 2011 survey of clinical practice patterns in the management of Graves’ disease. J Clin Endocrinol Metab. 2012;97:4549–58.
Sundaresh V, et al. Comparative effectiveness of therapies for Graves’ hyperthyroidism: a systematic review and network meta-analysis. J Clin Endocrinol Metab. 2013;98:3671–7.
Akamizu T, et al. Diagnostic criteria, clinical features, and incidence of thyroid storm based on nationwide surveys. Thyroid. 2016;22:661–79.
Bartalena L, et al. Treatment of amiodarone-induced thyrotoxicosis, a difficult challenge: results of a prospective study. J Clin Endocrinol Metab. 1996;81:2930–3.
Cooper DS, Laurberg P. Hyperthyroidism in pregnancy. Lancet Diabetes Endocrinol. 2013;1:238–49.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Cozzi, R. (2021). Overt Hyperthyroidism and Subclinical Hyperthyroidism: Who and How to Treat. In: Luzi, L. (eds) Thyroid, Obesity and Metabolism. Springer, Cham. https://doi.org/10.1007/978-3-030-80267-7_4
Download citation
DOI: https://doi.org/10.1007/978-3-030-80267-7_4
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-80266-0
Online ISBN: 978-3-030-80267-7
eBook Packages: MedicineMedicine (R0)