thyrotoxicosis

Thyrotoxicosis is a hypermetabolic clinical syndrome caused by a pathological excess of circulating free T4 (thyroxine) and/or free T3 (tri-iodothyronine).

Terminology

Although commonly done, thyrotoxicosis should not be confused with, nor is it synonymous with hyperthyroidism. The latter term solely means that a patient has abnormally-elevated thyroid hormone levels, and maybe subclinical. This may in turn lead to overt symptoms and signs, which is called thyrotoxicosis.

Clinical presentation

Signs and symptoms associated with thyrotoxicosis include :

  • nervousness, anxiety, hyperactivity
  • weight loss
  • muscle weakness, tremor
  • increased perspiration, heat intolerance
  • palpitations, tachycardia or atrial arrhythmia, systolic hypertension
  • stare and eyelid retraction (i.e. proptosis)
  • reduced menstrual flow

In subclinical thyrotoxicosis (normal serum free T4 and T3 with low TSH), the patient may not have any symptoms.

Pathology

The signs and symptoms attributed to thyrotoxicosis stem from the acceleration of normal physiological processes as a result of excessive serum concentrations of thyroid hormones.

Etiology

There are multiple causes of thyrotoxicosis :

Treatment and prognosis

Upon a precipitating event, “uncomplicated” thyrotoxicosis may transform into a thyrotoxic crisis (thyroid storm) if left unmanaged.