Hyperthyroidism Key Points

• Hyperthyroidism is diagnosed with a suppressed TSH and increased FT4.

• Graves' disease is caused by abnormal response to circulating antithyroid antibodies.

• Serum TSH in Graves' disease is usually less than 0.1 mIU/L and may be unmeasurable.

• Diagnosis of Graves' disease in a patient without goiter and ophthalmic abnormality should be suspect.

Hyperthyroidism is a biochemical process represented by an increase in thyroid hormone biosynthesis and secretion (Toft, 2001). Diagnosis of hyperthyroidism is based on (1) sTSH level less than 0.1 mIU/L and (2) elevated FT4 and/or T3, and is often associated with symptoms consistent with a hypermetabolic state (Box 35-2). Determining the exact etiology requires further testing that includes laboratory studies and imaging (Box 35-3).

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