|Thyrotoxicosis and Hyperthyroidism
|Thyroid Storm - Thyrotoxic crisis
|Graves Disease (Thyrotoxicosis)
|Amiodarone and Thyroid disease
|Thyroid Surgery (Thyroidectomy)
|Thyroid Function Tests and antibodies
|Post partum thyroiditis
|Sick Euthyroid Syndrome
|Thyroid Exam (OSCE)
|Thyroid Gland anatomy and Physiology
Screening Thyroid Function Tests
- Atrial fibrillation
- Diabetes mellitus (DM)
- Pregant and DM1 1st trimeter and post partum
- Amiodarone/Lithium every 6 months
- Downs syndrome Turners syndrme
- Addisons Disease
Interpreting Thyroid Function Tests
|TSH secreting Tumour||High||High|
|Slow converstion T4/3||High||Low||High|
|Sick euthyroid/pituitary disease||Low||Low||Low|
|Issues with assay/amiodarone/TSH tumour||Normal||Abnormal|
May be misdiagnosed as postnatal depression so be sure to check TFTS
- May be seen up to 1 yr post-delivery
- Often lasts several weeks to months
- Increased in diabetics, history of thyroid and autoimmune disease
- Histologically causes a lymphocytic thyroiditis.
- Initially hyperthyroid and then hypothyroid but either can occur
- Hyper: Anxiety, Irritability, Rapid heartbeat or palpitations, Unexplained weight loss, Increased sensitivity to heat, Fatigue, Tremor, Insomnia
- Hypo: Lack of energy, Increased sensitivity to cold
Constipation, Dry skin, Weight gain, Depression
- Mild or No eye signs, perhaps lid lag. Minimal thyroid enlargement
- TFTS: hypo (Low T4 high TSH) or hyper thyroid
(High T4 low TSH)
- High titre of anti-TPO antibodies
- Manage symptomatically - hyperthyroid may be transient. Use beta blockers.
- May not need usual antithyroid medications as phase is often transient.
- Monitoring and can proceed to hypothyroidism needing T4 replacement
- If T4 started this can be withdrawn after 12 months and reassessed to see if still needed.
- Most women will regain normal thyroid function within
12-18 months after the onset of symptoms.
approximately 20% of those that go into a hypothyroid
phase will remain hypothyroid.