Endocrinology & MetabolicPending review

Hyperthyroidism

A state of thyroid hormone excess that accelerates metabolic rate across almost every tissue, so the clinical picture (weight loss despite hunger, heat intolerance, tachycardia and tremor) can be derived directly from asking what a sped-up metabolism looks like.

In a nutshell

Thyroid hormone excess speeds up metabolism everywhere: weight loss despite hunger, heat intolerance, tachycardia or atrial fibrillation, tremor and anxiety. Graves' disease is autoimmune TSH-receptor stimulation, distinguished from nodular causes by suppressed TSH, positive TRAb and diffuse radionuclide uptake, plus unique eye and skin signs.

Classic presentation

A younger woman with weight loss despite increased appetite, heat intolerance, palpitations, tremor and a diffuse goitre, sometimes with eye signs.

Key points

TSH is suppressed in primary hyperthyroidism because excess T4/T3 feeds back on the pituitary; a low TSH with raised T4/T3 confirms it.

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Educational content pending clinical review. Not medical advice.