[Hyperthyroidism - a classic disease]

Abstract

Hyperthyroidism presents with various forms of generalized symptoms. Primary care physicians as well as other specialists should have this in mind when meeting patients with symptoms such as palpitations, sweating, fatigue and weight loss. Thyroid-stimulating hormone (TSH) is a highly specific test and useful in ruling out hyperthyroidism. The severity of the disease determines the pace of management. Primary care is often involved in detection of hyperthyroidism but also takes part in the work of rehabilitation and the lifelong hormonal substitution that is necessary for 2/3 of all patients. Subclinical hyperthyroidism, characterized by low TSH levels but normal levels of T4 and T3, is associated with increased mortality by 24 percent and risks of cardiovascular disease, atrial fibrillation and osteoporosis. Treatment depends on age, presence of comorbidity and TSH-levels. In addition to specific endocrinological treatment, person-centered care is crucial during active disease and rehabilitation. The first Swedish care program for hyperthyroidism aims to enhance care efficiency and equity.