Thyrotoxicosis - investigation and management

Clin Med (Lond). 2017 Jun;17(3):274-277. doi: 10.7861/clinmedicine.17-3-274.


Graves' disease (GD) and toxic nodular (TN) goitre account for most cases of thyrotoxicosis associated with hyperthyroidism. Hyperthyroidism is confirmed with measurement of a suppressed serum thyrotropin concentration (TSH) and elevated free thyroid hormones. The three therapeutic options are antithyroid drugs, radioactive iodine and surgery. Thionamides achieve long-term remission in 35% of cases. Many centres administer fixed doses of iodine-131; larger doses result in improved rates of cure at the cost of hypothyroidism. Surgery is usually considered for patients who have a large goitre, compressive symptoms or significant ophthalmopathy.

Keywords: Grave’s disease; radioiodine; thionamides; thyroidectomy; thyrotoxicosis.

Publication types

  • Review

MeSH terms

  • Antithyroid Agents / therapeutic use
  • Goiter, Nodular
  • Graves Disease
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Thyrotoxicosis* / diagnosis
  • Thyrotoxicosis* / physiopathology
  • Thyrotoxicosis* / therapy


  • Antithyroid Agents
  • Iodine Radioisotopes