Direct to an emergency department for:
- Hyperthyroidism complicated by cardiac, respiratory compromise or other indications of severe illness (fever, vomiting, labile blood pressure, altered mental state)
- Neutropenic sepsis in patient taking carbimazole or propylthiouracil
- Hyperthyroidism with hypokalaemia or paralysis.
Criteria for referral to public hospital specialist clinic services
- Assessment of newly identified or recurring hyperthyroidism (including Graves’ disease)
- Advice on, or review of, management plan for stable hyperthyroidism.
Information to be included in the referral
Information that must be provided
- Onset, characteristics and duration of symptoms
- Current and complete medication history (including non-prescription medicines, herbs and supplements), particularly medicines such amiodarone, lithium, biotin and kelp products
- Recent free triiodothyronine (T3), free thyroxine (T4) and thyroid stimulating hormone level (TSH)
- If the patient is pregnant.
Provide if available
- Anti- thyroid peroxidase (TPO) antibodies results
- Thyroid stimulating hormone receptor antibody (TRAb) or thyroid stimulating immunoglobulin (TSI) results
- Current and previous scan results (e.g. nuclear thyroid scan).
The Summary and referral information lists the information that should be included in a referral request.
Thyroid ultrasound is not useful in assessing hyperthyroidism.
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
Referral to a public hospital is not appropriate for