When treating hyperthyroidism, what is/are the target goals for TSH levels?
0.5-4.5 mIU/L
aggressive treatment: 0.5 - 2 mIU/L
*No specific standard exists
When treating hyperthyroidism, what are the three general goals of therapy?
1. Reach target TSH
2. Relieve symptoms
3. Minimize long term consequences
What are the long-term consequences of hyperthyroidism?
1. arrhythmia
2. osteoporosis
3. thyroid storm
When should surgical removal of the thyroid be considered in cases of hyperthyroidism?
Large thyroid (>80 grams)
Failure with antithyroid medications
First-line for multinodular goiter
What are the two possible preparations that should be made before surgical removal of the thyroid?
1. Antithyroid medication for 6-8 weeks
2. Iodides for 7-14 days
*get patient euthyroid (hyperthyroid states are not favorable for surgery)
Which type of hyperthyroidism involves
1. inflammation
2. is due to a viral infection
3. is associated with severe thyroid pain, fever, and a firm and tender gland
4. triphasic disease course
5. self-limiting (2-6 months)
Subacute thyroiditis
What treatment may be given to a patient with subacute thyroiditis?
Symptomatic relief with:
1. beta-blockers (to stop heart palpitations and jitteriness)
2. ASA
3. Prednisone
Which type of hyperthyroidism involves
1. inflammation
2. is due to autoimmunity
3. is painless
4. triphasic disease course
5. self-limiting
6. Frequently occurs post-partum
Painless thyroiditis
What treatment may be given to a patient with painless thyroiditis?
Symptomatic treatment (probably same as subacute thyroiditis).
What medications are associated with causing hyperthyroidism?
1. excessive exogenous thyroid hormone
2. amiodarone (can cause hyper and hypothyroidism, causes thyroid dysfunction in roughly 15% of pts)
How should amiodarone be monitored to avoid hyper/hypothyroidism?