Thyroid Hormone Toxicity Clinical Presentation

Updated: Apr 29, 2022
  • Author: Amanda Lu, MD; Chief Editor: Asim Tarabar, MD  more...
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Presentation

History and Physical Examination

History

Access to thyroid hormone or other pharmaceuticals, especially in pediatric or unknown ingestions, is important to diagnosis and management. Reported symptoms may include:

  • Abdominal pain
  • Nausea or vomiting
  • Diarrhea
  • Increased appetite
  • Insomnia
  • Anxiousness
  • Agitation
  • Tremor
  • Weakness

Physical examination

Focus the physical examination on findings consistent with symptoms of increased adrenergic activity as below.

Acute signs include:

  • Tachycardia

  • Palpitations or Arrhythmia

  • Hypertension or hypotension

  • Hyperpyrexia/heat intolerance

  • Tremor

  • Seizures

  • Weakness

  • Diaphoresis

  • Confusion

  • Psychosis

  • Hypoglycemia

  • Skin flushing

  • Transient systolic ejection murmurs

  • Pulmonary edema

  • Adrenal insufficiency

Chronic signs are as follows:

  • Weight loss

  • Menstrual irregularities

  • Supraventricular tachycardia (SVT)

  • High-output left ventricular failure

  • Hypotension

  • Hemiparesis

  • Delirium

  • Coma

  • Pneumonia

  • Sepsis

  • Hyperthermia

  • Acute renal failure

  • Myopathy

  • Palmar and plantar desquamation

  • Premature epiphyseal closure in children

  • Craniosynostosis (infants)