Persistent hyperthyroidism

Graves disease, hot nodules, and toxic multinodular goiters are the most common causes of persistent hyperthyroidism. 

The treatments for all three high-uptake hyperthyroid conditions are almost identical. The endocrinologists at Houston Thyroid and Endocrine will take the time to explain what may be the best treatment option tailored to each patient's circumstances.  



Hot nodule

 Toxic multinodular goiter

 Age of onsetPeak age 40 years 40-50 years in iodine deficient areas >50 years with nodular goiter in iodine deficient areas
 Prevalence2% in areas of normal iodine intake 10% in iodine deficient areas 50% in iodine deficient areas
 CauseThyroid stimulating immunoglobulinsActivating mutation in the TSH receptor    Activating mutation in the TSH receptor
 Cardiac changesHeat intolerance, tremor, fast heart rates. Possible autoimmune valve disease.  Milder than Graves with mostly arrhythmiasMilder than Graves. Most patients already with underlying heart disease so atrial fibrillation can be first manifestation of subclinical or overt hyperthyroidism