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Hashitoxicosis

‘Leakage’ symptoms of active Hashimoto’s disease

- Hashitoxicosis (Htx) can occur during the initial hyperthyroid stage in
in Hashimoto’s thyroiditis ... hormone (hyperthyroidism ... enough of it (hypothyroidism ... is depleted and hypothyroidism ... - Thyroiditis
Thyroid Disorders - Differential Diagnosis Algorithm
Hypothyroidism:
 • Hasimoto’s
 • Radioactive Iodine 
 • Hypopituitarism
 • Iodine
Thyroid Disorders ... Diagnosis Algorithm Hypothyroidism ... Subclinical Hyperthyroidism ... Toxic Nodular • Thyroiditis ... @AmyChung #Thyroid
Hypothyroidism - Differential Diagnosis Algorithm
Central Hypothyroidism
 • Isolated TSH Deficiency
 • Panhypopituitarism
Thyroid Hormone Resistance
Iatrogenic
Primary Hypothyroidism
 -
Panhypopituitarism Thyroid ... Granulomatous • Thyroiditis ... • Post-Partum Thyroiditis ... • Fibrous Thyroiditis ... - Congenital Thyroid
Laboratory Evaluation of Patients for Thyroid Disease 
Hyperthyroidism:
 • Graves disease - TSH low; free T4
Disease Hyperthyroidism ... tissue • Subacute thyroiditis ... uptake • Painless thyroiditis ... iodine uptake Hypothyroidism ... • Hashimoto thyroiditis
Differentiation of Causes of Hyperthyroidism According to Pattern of Radionucleotide Uptake
Reduced uptake:
 • Thyroiditis
 • Exogenous
Differentiation of Causes of Hyperthyroidism ... Reduced uptake: • Thyroiditis ... loading • Ectopic thyroid ... disease • Excess thyroid-stimulating ... differential #diagnosis #hyperthyroidism
Hyperthyroidism - Differential Diagnosis Algorithm
High/Normal Radioiodine Uptake
 - Autoimmune Thyroid Disease:
    • Grave's
Hyperthyroidism ... - Autoimmune Thyroid ... - Autonomous Thyroid ... Uptake - Subacute Thyroiditis ... Struma Ovarii #Hyperthyroidism
Approach to the Diagnosis of Hyperthyroidism - Differential Diagnosis and Workup Algorithm

 • Secondary Hyperthyroidism (↑↔TSH,
the Diagnosis of Hyperthyroidism ... • Secondary Hyperthyroidism ... Early Hashimoto thyroiditis ... hashitoxicosis) • Thyroiditis ... • Exogenous thyroid
Hyperthyroidism Overview

Clinical Manifestation of Hyperthyroidism:
 • Fatigue
 • Weight loss
 • Heat intolerance
 • Depression, nervousness
Hyperthyroidism ... Manifestation of Hyperthyroidism ... associated with thyroiditis ... ↑ Free T4 • Thyroid ... suspected • Thyroid
Hashitoxicosis - Autoimmune thyroid disease overlap syndrome of Graves' and Hashimoto's disease

Autoimmune thyroid disease overlap syndrome
Autoimmune thyroid ... Hashimoto’s Disease → Hypothyroidism ... Grave’s Disease → Hypothyroidism ... develop spontaneous hypothyroidism ... from Hashimoto's thyroiditis
Amiodarone Thyroid Complications
Amiodarone: 
 - iodine-rich, similar structure to T4, with half life up to 100d
Amiodarone Thyroid ... directly toxic to thyroid ... pts w/ latent thyroid ... to destructive thyroiditis ... Amiodarone Induced Hypothyroidism