Symptomatic management of thyrotoxicosis

Symptomatic control of adrenergic manifestations of thyrotoxicosis before euthyroidism is achieved: tachycardia, tremor, anxiety, sweating. ATA 2016 recommends non-selective beta-blockers.

ICD-10 E051 drug

Also known as: Adrenergic symptoms in hyperthyroidism

Drugs used for this condition

BPropranololFirst line · Non-selective beta blockerPropranolol controls adrenergic symptoms of thyrotoxicosis (tachycardia, tremor, anxiety) until euthyroidism is achieved with antithyroid drugs or radioactive iodine. ATA 2016 recommends non-selective beta-blockers as the standard; propranolol additionally inhibits peripheral T4-to-T3 conversion, reinforcing the therapeutic effect. Doses 40–160 mg/day in 3–4 divided doses. Selective alternatives – metoprolol, atenolol – are used in patients with bronchial obstruction.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit