In the hyperthyroid phase, patients may benefit from beta blockers if symptomatic (e.g., atenolol 25-50 mg daily, titrate for HR < 90 if BP allows). Monitor closely with regular symptom evaluation and fT4 testing every 2 weeks
Introduce thyroid hormones (see hypothyroidism management) if the patient becomes hypothyroid (low T4/T3, even if TSH is not elevated)
Assessment and Investigations
Thyroid function tests (fT3, fT4, TSH)
Anti-TPO, TSI
Thyroid echography (nodule?)
Medication history: amiodarone or lithium therapy
Suspect Graves’ disease if :
– pretreatment by anti-CTLA-4
– persistant hyperthyroidism beyond 6 weeks