| Cause | Pathophysiology | Gland size* | Nodularity | Tenderness |
|---|---|---|---|---|
Toxic adenoma
|
Autonomous hormone production
|
Decreased
|
Single nodule
|
Nontender
|
Toxic multinodular goiter
|
Autonomous hormone production
|
Increased
|
Multiple nodules
|
Tender
|
Subacute thyroiditis
|
Leakage of hormone from gland
|
Increased
|
None
|
Tender
|
Lymphocytic thyroiditis, postpartum thyroiditis, medication-induced thyroiditis
|
Leakage of hormone from gland
|
Moderately increased
|
None
|
Nontender
|
Graves’ disease (thyroid-stimulating antibody)
|
Increased glandular stimulation (substance causing stimulation)
|
Increased
|
None
|
Nontender
|
Iodine-induced hyperfunctioning of thyroid gland (iodide ingestion, radiographic contrast, amiodarone [Cordarone])
|
Increased glandular stimulation (substance causing stimulation)
|
Increased
|
Multiple nodules or no nodules
|
Nontender
|
Functioning pituitary adenoma (thyroid-stimulating hormone); trophoplastic tumors (human chorionic gonadotropin)
|
Increased glandular stimulation (substance causing stimulation)
|
Increased
|
None
|
Nontender
|
Factitial hyperthyroidism
|
Exogenous hormone intake
|
Decreased
|
None
|
Nontender
|
Struma ovarii; metastatic thyroid cancer
|
Extraglandular production
|
Decreased
|
None
|
Nontender
|
Time course of changes in thyroid function tests in patients with thyroiditis. (T4= thyroxine; T3= triiodothyronine; TSH = thyroidstimulating hormone.)
Diagnosing Hyperthyroidism
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