Thyrotoxicosis is a clinical state resulting from excess thyroid hormone in the body. It is clinically characterized by weight loss, palpitation, and shortness of breath, weakness, heat intolerance and nervousness.

Diagnosis

• Is mainly clinical,
• Determination of serum thyroid hormones confirms the diagnosis and
• TSH radioactive iodine uptake is also helpful.

Treatment

First Line

Propylthio-uracil, 100-450 mg, p.o. daily divided into three to four doses.

S/E: Leukopenia, allergy, agranulocytosis, hepatitis, drug fever, arthralgia;

C/I: impaired liver function

Dosage forms: Tablet, 25mg, 100mg

Note: Duration of treatment depends on the specific cause of the hyperthyroidism. In Grave's disease, PTU can be stopped after 1-2 years of treatment. In case of Toxic nodular goiter, treatment with PTU should be continued almost indefinitely.

PLUS

Propranolol, 10-120 mg p.o. daily divided in to 2-3 doses. (For S/E, C/I and Dosage forms, see page 46)

Note:

Propranolol is given until anti-adrenergic sings and symptoms subside.
Radioactive iodine (131 I), 150-370 MBq (4-10 millicuries)