Thyroid Gland Disorders

Abstract

Most laboratories now perform thyroid function tests in the form of three T3, free T4 and TSH levels, these measurements not being influenced by changes in the thyroid binding proteins, mainly TBG and albumin. Most cases of hyperthyroidism are due to the Graves Disease and the treatment of choice for all patients over the age of 18 is radio-iodine. Far too many operations for hyperthyroidism take place in the private sector in South Africa and the blame for this must rest with the general practitioner who arranges the initial referral to a surgeon rather than a physician. In areas where I131 therapy is not available, an initial one year treatment with carbimazole is indicated, remembering to start with a high dose and reduce when biochemical euthyriodism is achieved. The treatment of choice for hypothyroidism is given. All patients with a previous history of thyroid dysfunction require lifelong follow-up by their GPs at approximately yearly intervals, and the use and abuse of thyroid scans are discussed.