Hyperthyroidism

De Leo, Simone; Lee, Sun Y; Braverman, Lewis E

doi:10.1016/s0140-6736(16)00278-6

Cited by 883Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryOphthalmology and Eye Disorders

Hyperthyroidism

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De Leo, Simone, Lee, Sun Y, Braverman, Lewis E·2016·The Lancet

DOI 10.1016/s0140-6736(16)00278-6PMC PMC5014602

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Abstract

Hyperthyroidism is characterised by increased thyroid hormone synthesis and secretion from the thyroid gland, whereas thyrotoxicosis refers to the clinical syndrome of excess circulating thyroid hormones, irrespective of the source. The most common cause of hyperthyroidism is Graves' disease, followed by toxic nodular goitre. Other important causes of thyrotoxicosis include thyroiditis, iodine-induced and drug-induced thyroid dysfunction, and factitious ingestion of excess thyroid hormones. Treatment options for Graves' disease include antithyroid drugs, radioactive iodine therapy, and surgery, whereas antithyroid drugs are not generally used long term in toxic nodular goitre, because of the high relapse rate of thyrotoxicosis after discontinuation. β blockers are used in symptomatic thyrotoxicosis, and might be the only treatment needed for thyrotoxicosis not caused by excessive production and release of the thyroid hormones. Thyroid storm and hyperthyroidism in pregnancy and during the post-partum period are special circumstances that need careful assessment and treatment.

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Hyperthyroidism results in reduced acid secretion with histamine-resistant achlorhydria as shown by 16% of such patients.
“Hyperthyroidism results in reduced acid secretion with histamine-resistant achlorhydria as shown by 16% of such patients (Dotevall et al., 1967; De Leo et al., 2016).”
From Thyroid disorders and gastrointestinal dysmotility: an old association (2024) · cites this paper as De Leo et al., 2016
The Clinical presentation and complications section discusses symptoms of excess thyroid hormone but does not address gastric acid secretion. Searches of our full-text copy for histamine-resistant achlorhydria, reduced gastric acid secretion, the 16% figure, and Dotevall found no passage supporting the claim. (LLM, conf=0.76)
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Etiologies associated with TPP include Graves' disease, toxic multinodular goiter, toxic thyroid adenoma, TSH-secreting pituitary adenomas, painless thyroiditis, and levothyroxine use.
“Etiologies associated with TPP include Graves' disease, toxic multinodular goiter, toxic thyroid adenoma, thyroid-stimulating hormone (TSH) secreting pituitary adenomas, painless thyroiditis, and in patients taking levothyroxine [4].”
From Thyrotoxic Periodic Paralysis With Hypokalemia: A Case Study (2023) · cites this paper as [4]

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Pezeshki, B., Pourmontaseri, H., Homayounfar, R., Moghaddam, M. T., & Dehghan, A. (2023) · BMC Endocrine Disorders · doi:10.1186/s12902-023-01467-3 · Cited by 3 · see citing works
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Authors: De Leo, S., Lee, S. Y., & Braverman, L. E.
Affiliations: Boston University (US)
Corresponding author: Braverman, Lewis E
ORCID: Lee, Sun Y
Braverman, Lewis E
Venue: The Lancet
Publisher: Elsevier BV
Published: 2016-08
Volume: 388
Issue: 10047
Pages: 906-918
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(16)00278-6
PMC: PMC5014602
OpenAlex: W4211256569
Cited by: 883
References: 144
Citations by year: 2026: 64 · 2025: 64 · 2024: 108 · 2023: 122 · 2022: 110 · 2021: 95 · 2020: 146 · 2019: 73 · 2018: 53 · 2017: 40 · 2016: 7
FWCI: 8.39
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: Fondazione Bracco
National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007201)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
Keywords: hyperthyroidism, thyrotoxicosis, Graves' disease, toxic nodular goiter, thyroiditis, drug-induced thyroid dysfunction, antithyroid drugs, radioiodine therapy, thyroidectomy, beta-blockers, thyroid storm, hyperthyroidism in pregnancy
MeSH terms: Adrenergic beta-Antagonists, Amiodarone, Diagnosis, Differential, Drug Administration Schedule, Female, Graves Disease, Humans, Hyperthyroidism, Iodine Radioisotopes, Patient Care Team, Pregnancy, Pregnancy Complications, Risk Factors, Antithyroid Agents, Thyroid Crisis, Thyroid Gland, Thyroid Hormones, Thyroidectomy, Thyrotoxicosis, Practice Guidelines as Topic

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