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Thyrotoxicosis

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Thyroid Disease and Reproduction

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Abstract

Thyrotoxicosis results from excess thyroid hormone due to either excess production (hyperthyroidism) or release of preformed thyroid hormone from the gland (thyroiditis). The prevalence of thyrotoxicosis is 1–2% in women and 0.1–0.2% in men. Graves’ disease, which is caused by activating thyrotropin receptor antibodies, is the most common cause of hyperthyroidism. Nodular thyroid disease is the second most common cause with multinodular goiter being more common than toxic adenoma. Thyroiditis is caused by inflammation of the thyroid gland from various etiologies that results in the release of stored thyroid hormone. Classic symptoms of thyrotoxicosis include palpitations, tremor, diaphoresis, restlessness, insomnia, anxiety, heat intolerance, weight loss, and hyperdefecation. Graves’ orbitopathy may also be present in 25–70% of patients with Graves’ disease. Treatment of Graves’ disease and nodular thyroid disease focuses on reducing the symptoms of hyperthyroidism with beta-blockade and decreasing further production of thyroid hormone. The latter can be done with antithyroid drugs (methimazole, propylthiouracil) and/or definitive therapy with radioactive iodine or surgery. On the other hand, treatment of thyroiditis focuses on symptomatic management with beta-blockers and does not require antithyroid drugs. Long-term prognosis is generally favorable if the condition is recognized and treated appropriately.

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Abbreviations

AIT:

Amiodarone-induced thyrotoxicosis

ATA:

American Thyroid Association

ATD:

Antithyroid drugs

FT3:

Free triiodothyronine

FT4:

Free thyroxine

GO:

Graves’ orbitopathy

LFTs:

Liver function tests

MMI:

Methimazole

MNG:

Multinodular goiter

PTU:

Propylthiouracil

RAI:

Radioactive iodine

SSKI:

Saturated solution of potassium iodide

TA:

Toxic adenoma

TBG:

Thyroxine-binding globulin

TFTs:

Thyroid function tests

TMNG :

Toxic multinodular goiter

TRAb:

Thyrotropin receptor antibody

TSH:

Thyroid-stimulating hormone

WBC:

White blood cell

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Authors and Affiliations

  1. Duke University Medical Center, Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Durham, NC, USA

    Adva Eisenberg, Rebecca Herbst & Tracy L. Setji

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  1. Adva Eisenberg
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  2. Rebecca Herbst
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  3. Tracy L. Setji
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Correspondence to Adva Eisenberg .

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Editors and Affiliations

  1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA

    Jennifer L. Eaton

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Eisenberg, A., Herbst, R., Setji, T.L. (2019). Thyrotoxicosis. In: Eaton, J. (eds) Thyroid Disease and Reproduction. Springer, Cham. https://doi.org/10.1007/978-3-319-99079-8_3

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  • DOI: https://doi.org/10.1007/978-3-319-99079-8_3

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