Hyperthyroidism
Find the cause of thyrotoxicosis with TRAb and, if needed, a technetium scan, then choose between carbimazole, radioactive iodine and surgery, with Graves orbitopathy and agranulocytosis as the traps.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Thyrotoxicosis is the clinical state of excess thyroid hormone. Hyperthyroidism is thyrotoxicosis from an overactive gland. Thyroiditis causes thyrotoxicosis without hyperthyroidism, and antithyroid drugs don't help it.
- Graves disease causes about 70 to 80% of hyperthyroidism in Australia. Toxic multinodular goitre and toxic adenoma are commoner in older people.
- TRAb first. A technetium scan if TRAb is negative or the gland is nodular.
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Sources
- 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosisAmerican Thyroid Association (Ross et al., Thyroid 2016;26:1343-421), 2016 (current ATA hyperthyroidism guideline, checked against the ATA guideline list November 2026)
- 2018 European Thyroid Association guideline for the management of Graves' hyperthyroidismEuropean Thyroid Association (Kahaly et al., Eur Thyroid J 2018;7:167-86), 2018
- The 2021 European Group on Graves' Orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves' orbitopathyEUGOGO (Bartalena et al., Eur J Endocrinol 2021;185:G43-67), 2021
- Management of thyroid eye disease, a consensus statement by the American Thyroid Association and the European Thyroid AssociationATA and ETA (Burch et al., Thyroid 2022;32:1439-70), 2022
- American Thyroid Association 2026 guidelines for thyroid disease in preconception, pregnancy, and postpartumAmerican Thyroid Association (Korevaar, Leung, Alexander et al., Thyroid 2026;36(5):481-544), 2026 (replaces the 2017 ATA pregnancy guideline; full text paywalled, key recommendations read via the 2026 editorial summary below, November 2026)
- Navigating the RCOG 2025 and ATA 2026 guideline updates on the management of thyroid disorders during pregnancyAthanasiadou KI, Peppa M, Kalantaridou SN, Paschou SA. Case Rep Womens Health 2026, 2026 (editorial)
- Teprotumumab (Tepezza): PBS medicine statusAU/NZPharmaceutical Benefits Scheme, Updated 31 October 2026 (listed 1 November 2026)
- Endocrinology (Therapeutic Guidelines)AU/NZTherapeutic Guidelines Ltd
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Deploy to Cloudflare on push to main