Medical history (history of illness) represents an important component in the diagnosis of hyperthyroidism (hyperthyroidism).
Family history
- Is there a frequent history of thyroid disease in your family?
Social history
- Is there any evidence of psychosocial stress or strain due to your family situation?
Current medical history/systemic history (somatic and psychological complaints).
- What symptoms have you noticed?
- Hyperactivity
- Irritability/nervousness
- Heat intolerance
- Sweating
- Palpitations (heart palpitations)
- Weight loss
- Increased appetite
- Diarrhea
- Nausea
- Vomiting
- Trembling
- Warm moist skin
- Insomnia
- Rapid pulse
- Foreign body sensation in the eyes and increased lacrimation
- Have you noticed any protrusion of the eyes and associated widening of the palpebral fissures?
- Do you have any other complaints, such as:
- High fever (> 40 °C; up to 41 °C).
- Fatigue
- Weakness
- Increased urine output (> 2 liters/24 hours)
- Infrequent menstrual bleeding (prolongation of the total cycle to more than 35 days to a maximum of 90 days).
- Loss of libido
- Enlargement of the thyroid gland
- Change in body weight:
- :Weight loss
- Weight gain – in 5-10% of sufferers due to increased appetite.
- Lack of concentration
- Redness of the palm
- Dysphagia
- Itching
- Hair loss
- Enlargement of the mammary gland in men
Vegetative anamnesis including nutritional anamnesis.
- Has there been any change in bowel movements? Diarrhea?
- Has your body weight changed unintentionally? Please tell us your body weight (in kg) and height (in cm).
- Do you smoke? If yes, how many cigarettes, cigars or pipes per day?
Self history including medication history.
- Pre-existing conditions (thyroid disease)
- Radiotherapy
- Operations
- Allergies
- Pregnancies
Medication history
- Amiodarone (iodine-containing antiarrhythmic drug; agent for cardiac arrhythmias) – in 40% of cases, therapy-resistant thyroid dysfunction (thyroid dysfunction) occurs during amiodarone therapy; this is caused by the high iodine content or immune-related cytotoxic effects. Two types of amiodarone-induced hyperthyroidism (AIH) are distinguished:
- AIH type I (thyrotoxicosis induced by jodexcess (crisis-like exacerbation of hyperthyroidism) in preexisting thyroid disease).
- AIH type II (amiodarone-triggered inflammatory-destructive effect on the thyroid gland with increased thyroid hormone release).
- Interferon-α
- Interleukin-2, tyrosine kinase inhibitor
- Lithium
- Iodine-containing contrast mediaNote: Contraindicated in manifest hyperthyroidism (absolute avoidance); in latent (subclinical) hyperthyroidism, use of iodine-containing contrast media only under thyrostatic protection (perchlorate and thiamazole shortly before the examination and 2 weeks afterwards, so that iodine uptake by the thyroid gland is no longer possible).
- Iodine excess (50-60% of hyperthyroidism in old age is iodine-induced).
