I saw a 32-year-old man in consultation for hyperthyroidism. His thyroid-stimulating hormone was <0.01 and both free T4 and free T3 were elevated. He had palpitations, tremor and insomnia but denied other symptoms. On exam, his thyroid was non-tender and without nodules. More than likely his diagnosis is Graves’ disease, I thought.
After discussing the treatment options in detail, we both leaned towards methimazole (Tamazole, King). At first, I did not think that radioactive iodine uptake and scan would be needed as we were not planning on radioactive iodine therapy.