Subclinical Hyperthyroidism Calculator

Subclinical Hyperthyroidism Calculator
Summary: How to proceed once you've detected a low TSH level.[/html]
Thyroid Stimulating Hormone (TSH) is LOW.
Obtain Free Triiodothyronine (T3) and Free Thyroxine (T4) levels <-- [select name="Q1" value="choose below...=0|T3 and T4 levels are both normal=1|free T3 is high and free T4 is normal=2|both T3 and T4 are high=3"][conditional field="Q1" condition="(Q1).is('T3 and T4 levels are both normal=1')"]
Obtain radioactive iodine thyroid scan and uptake test <-- [select name="Q2" value="choose below...=0|Increased or normal uptake - localized distribution=10|Increased or normal uptake - diffuse distribution=20|Decreased uptake=30"][/conditional][conditional field="Q1|Q2" condition="(Q1).is('T3 and T4 levels are both normal=1')&&(Q2).is('Decreased uptake=30')"]
Get thyroglobulin level <-- [select name="Q3" value="choose below...=0|Thyroglobulin level increased=100|Thyroglobulin level decreased=200"][/conditional][conditional field="Q1" condition="(Q1).is('free T3 is high and free T4 is normal=2')"]
DIAGNOSIS --> T3 thyrotoxicosis.
RECOMMENDATION --> TSH, T3, and T4 should be rechecked after 2 to 4 months - to assess if low TSH has persisted and also whether T3 and T4 have become overtly elevated.[/conditional][conditional field="Q1" condition="(Q1).is('both T3 and T4 are high=3')"]
DIAGNOSIS --> overt hyperthyroidism.[/conditional][conditional field="Q1|Q2" condition="(Q1).is('T3 and T4 levels are both normal=1')&&(Q2).is('Increased or normal uptake - localized distribution=10')"]
DIAGNOSIS --> subclinical hyperthyroidism - toxic nodular or multinodular goiter.
RECOMMENDATION --> TSH, T3, and T4 should be rechecked after 2 to 4 months - to assess if low TSH has persisted and also whether T3 and T4 have become overtly elevated.[/conditional][conditional field="Q1|Q2" condition="(Q1).is('T3 and T4 levels are both normal=1')&&(Q2).is('Increased or normal uptake - diffuse distribution=20')"]
DIAGNOSIS --> subclinical hyperthyroidism - Graves disease.
RECOMMENDATION --> TSH, T3, and T4 should be rechecked after 2 to 4 months - to assess if low TSH has persisted and also whether T3 and T4 have become overtly elevated.[/conditional][conditional field="Q1|Q2|Q3" condition="(Q1).is('T3 and T4 levels are both normal=1')&&(Q2).is('Decreased uptake=30')&&(Q3).is('Thyroglobulin level increased=100')"]
DIAGNOSIS --> subclinical hyperthyroidism - subacute thyroiditis.
RECOMMENDATION --> TSH, T3, and T4 should be rechecked after 2 to 4 months - to assess if low TSH has persisted and also whether T3 and T4 have become overtly elevated.[/conditional][conditional field="Q1|Q2|Q3" condition="(Q1).is('T3 and T4 levels are both normal=1')&&(Q2).is('Decreased uptake=30')&&(Q3).is('Thyroglobulin level decreased=200')"]
DIAGNOSIS --> exogenous thyroid hormone.[/conditional]
[checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"]
reference:
[link url="//www.aafp.org/afp/2011/0415/p933.html" memo="#1"] Am Fam Physician. 2011 Apr 15;83(8):933-938.
[/conditional]