Key messages

• Sometimes treatment for presumed thyroid disease will have to be initiated before the results of diagnostic tests are available.

• The determination of the rapidity with which the patient needs to be treated is of utmost importance.

• Therapy should reduce both serum thyroid hormone levels and the action of thyroid hormones on peripheral tissues as well as treat any precipitating event.

• A combination of antithyroid drugs and iodine may decrease serum tri-iodothyronine levels in days although the metabolic response lags behind.

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