Hyperthyroidism
Also known as: Graves disease · thyroid storm · thyrotoxicosis
Free to read — no account needed. Sign in only to bookmark this disease and track your study progress.
2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis
American Thyroid Association (ATA) · 2016
The ATA's guideline covers the evaluation of thyrotoxicosis and the treatment options for hyperthyroidism, including antithyroid drugs, radioactive iodine and surgery.
2018 European Thyroid Association Guideline for the Management of Graves' Hyperthyroidism
European Thyroid Association (ETA) · 2018
The ETA guideline sets out how to diagnose Graves' hyperthyroidism and compares the three main treatment routes — antithyroid drugs, radioiodine and thyroidectomy — including guidance for special populations.
- It recommends measuring TSH receptor antibodies for diagnosis and differential diagnosis, before stopping antithyroid drugs, and during pregnancy. source
- Methimazole is described as the preferred first-line drug, with a switch to propylthiouracil when pregnancy is planned and in the first trimester. source
US vs EU key differences
- First-line therapy differs: the ETA 2018 guideline directs that newly diagnosed Graves' hyperthyroidism be treated with antithyroid drugs, with radioiodine or surgery only if the patient prefers them, whereas the ATA 2016 guideline presents radioiodine, antithyroid drugs and thyroidectomy as three acceptable modalities chosen by patient preference. source
- The European guideline positions radioiodine as second-line — reserved for antithyroid drug side effects or relapse after a course of therapy — rather than as a co-equal initial option. source
- Diagnostic workup differs: the ETA leans on TSH-receptor antibody measurement plus thyroid ultrasound with Doppler as the standard route to diagnosis, reserving scintigraphy for coexisting nodularity or pre-radioiodine assessment. source
- Both sides converge on a defined methimazole course of roughly 12–18 months, stopped once TSH and TSH-receptor antibody levels have normalised. source
What changed recently
- US2011 → 20162016-10-01
The 2016 ATA guidelines replaced the 2011 ATA/AACE hyperthyroidism guidelines, giving third-generation TSH-receptor antibody testing a central role in establishing the cause of thyrotoxicosis and in deciding whether antithyroid drugs can be stopped or should be continued. They also revised antithyroid drug management in pregnancy and added preoperative assessment and repletion of calcium and vitamin D before thyroidectomy.
See the full update feed for changes across every system.