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).

Additional comments

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

Not applicable.