Clinical management of patients with hyperthyroidism

This article will be devoted to a detailed discussion of the management of the hyperthyroid patient. The selection of appropriate therapy for the hyperthyroid patient is critically dependent on determining that the patient has true hyperthyroidism and not one of the many forms of euthyroid hyperthyroxinemia⁸ and establishing the etiology of the hyperthyroidism. Since hyperthyroidism is a syndrome with multiple etiologies, recognition of its various causes is crucial for proper patient management. Other factors also enter into the decision regarding therapy, including patient sex and age, the severity of the hyperthyroidism, the presence of other medical problems, patient preference, and the experience and background of the physician. Some aspects of treatment are controversial, and the opinions expressed below are, in many instances, only guidelines reflecting the management of hyperthyroid patients in the Massachusetts General Hospital Thyroid Clinic.