Determination of Etiology

Graves' Disease

TMNG or TA

Subclinical Hyperthyroidism and Pregnancy

Other Conditions

Document Overview

Design and created by Guideline Central in participation with the American Thyroid Association.

Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis

American Thyroid Association

Publication Date: Oct 1, 2016

Page Last Updated: May 5, 2026

Recommendation Grading

Grade	Rating	Rating Definition
Strength of Recommendation
S	Strong	Benefits clearly outweigh risks and burden, or risks and burden clearly outweigh benefits
W	Weak	Benefits finely balanced with risks and burden
N	None	Insufficient evidence to determine net benefits or risks
Quality of Evidence
H	High	Requires one or more randomized, controlled trials without important limitations, or overwhelming evidence from observational studies
M	Moderate	Derived from trials with important limitations, or exceptionally strong observational studies
L	Low	Supported only by observational studies or case series
I	Insufficient for grading	Evidence is lacking, of poor quality, or conflicting

Adapted from: Qaseem A. Ann Intern Med 2010;153:194-199

Document Overview

Document Title: Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis

Authoring Society: American Thyroid Association

Document Publication Date: Oct 1, 2016

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: www.liebertpub.com/doi/full/10.1089/thy.2016.0229

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Scope: Assessment and Screening, Management

Keywords: Graves' disease, hyperthyroidism, thyroidtoxicosis

Target Patient Population: patients with thyrotoxicosis

Target Provider Population: general and subspecialty physicians and others providing care for patients with thyrotoxicosis

Inclusion Criteria: Male, Female, Adolescent, Adult, Child, Older Adult

Health Care Settings: Ambulatory

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents: 677

Literature Search Start Date: Saturday, January 1, 2011

Literature Search End Date: Monday, June 6, 2016

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: No

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Identifies study selection process?: No

Identifies study selection criteria?: No

Identifies methods used to evaluate and analyze the evidence?: Yes

Identifies key questions addressed by the systematic review?: Yes

Identifies search strategy?: No

Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis

Determination of Etiology

Symptomatic Management

Graves' Disease

RAI

ATDs

Iodine

Thyroidectomy

Thyroid Nodules in GD

Thyroid Storm

Graves' Orbitopathy (GO)

Children and Adolescents

General

ATD

RAI (For Cancer Risk See Table 15)

Surgery

TMNG or TA

RAI

Surgery

ATDs

Ethanol or Radiofrequency Ablation

Subclinical Hyperthyroidism and Pregnancy

Subclinical Hyperthyroidism (SH)

Pregnancy

Postpartum Thyroiditis

Other Conditions

Drug-Associated Thyrotoxicosis

Iodine-induced Hyperthyroidism

Amiodarone-induced Thyrotoxicosis (AIT)

Destructive Thyroiditis

Subacute Thyroiditis

Painless Thyroiditis

Acute Thyroiditis

Unusual Causes of Thyrotoxicosis

TSH-Secreting Pituitary Tumors

Struma Ovarii

Choriocarcinoma

Recommendation Grading

Document Overview

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology