All cases of thyrotoxicosis should be referred to endocrinology:
- The lab will automatically add TSH Receptor Antibodies (TRAbs) to all new thyrotoxic bloods
- No further investigations are needed prior to referral
- If patients are very symptomatic, consider treatment with propranolol 40mg t.d.s., or with a rate-limiting calcium channel blocker (e.g. verapamil) if beta-blockade is contraindicated.
- Consultants may provide advice on treatment when triaging a new patient with Graves’ disease. However, if there is concern that the patient is significantly unwell (e.g. significant tachycardia, uncontrolled atrial fibrillation) advice on initial management can be provided by paging the on call endocrine registrar at RIE or WGH.
CM & NZ 29/09/25
Who to refer
Anyone who is hyperthyroid
How to refer
Via SCI Gateway to Endocrinology at RIE / WGH / St John’s.
If significantly unwell (see above) please contact the on call endocrine registrar at RIE or WGH.
