Diagnosis and Treatment of Hyperthyroidism

This chapter deals with the current management of patients presenting with an excess of circulating thyroid hormones. This condition is known under two different words: hyperthyroidism and thyrotoxicosis describing two distinct pathologic conditions that should be recognized at diagnosis because they have a different natural history and may have different therapeutic approaches. The hypertiroidism indicates a condition determined by an excessive synthesis of thyroid hormones by the thyroid tissue, any cause. In the United States hyperthyroidism has a prevalence of approximately 1.2% of the population. The most common cause is Graves’ disease (GD), followed by toxic nodular goiter, whose prevalence increases with age, particularly in the regions of iodine deficiency, or single hyperfunctioning thyroid adenoma (Plummer’s adenoma) and, more rarely a TSH-producing pituitary adenoma. The thyrotoxicosis reflects any medical condition associated with high levels of thyroid hormones in the blood, secondary to destructive process of the thyroid or caused by improper intake of drugs or supplements containing thyroid hormones. In this manuscript the Authors report the main important condition of of hyperthyroidism and thyreotoxicosis, the current approaches for their diagnosis, and the options for the treatment of patients (medical treatments, radioisotopic treatment). The most important drugs used in the clinical practice are examined, and some clinical recommendations before particular treatments are reported.