TABLE 2061 Causes of Thyrotoxicosis

Classically, patients with hyperthyroidism may complain of heat intolerance, palpitations, weight loss, sweating, tremor, nervousness, weakness, and fatigue ( Table.. 2.0.6-2). An individual with hyperthyroidism who is exhibiting only mild symptoms may be safely referred for further evaluation as an outpatient. Clinical suspicion of hyperthyroidism is confirmed by thyroid function tests. An elevated free T4 and a low or undetectable TSH level is consistent with a diagnosis of hyperthyroidism. In some cases of Graves' disease, the T4 level may be normal and the TSH level decreased but the patient appears to be thyrotoxic. A T 3 level should be determined to rule out T3 toxicosis. Patients with hyperthyroidism secondary to pituitary adenomas will have elevated TSH.

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