Weight loss, increased appetite, tremor and goiter with labs showing TSH <0.01 mIU/L and FT4 38 pmol/L indicate which condition?

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Multiple Choice

Weight loss, increased appetite, tremor and goiter with labs showing TSH <0.01 mIU/L and FT4 38 pmol/L indicate which condition?

Excess thyroid hormone speeds up metabolism and stimulates the sympathetic system, which explains weight loss with increased appetite and tremor, and the goiter from the gland’s overactivity. The lab pattern shows a very low TSH, because high thyroid hormone feeds back on the pituitary to shut off TSH production, and a high free T4, confirming the thyroid is overactive. This combination—suppressed TSH with elevated FT4—points to primary hyperthyroidism (the problem is in the thyroid itself), rather than hypothyroidism (high TSH, low FT4) or euthyroid (normal values). Thyroid storm is an acute, severe hyperthyroid state, but the underlying hormone pattern here still reflects hyperthyroidism as the condition.

Excess thyroid hormone speeds up metabolism and stimulates the sympathetic system, which explains weight loss with increased appetite and tremor, and the goiter from the gland’s overactivity. The lab pattern shows a very low TSH, because high thyroid hormone feeds back on the pituitary to shut off TSH production, and a high free T4, confirming the thyroid is overactive. This combination—suppressed TSH with elevated FT4—points to primary hyperthyroidism (the problem is in the thyroid itself), rather than hypothyroidism (high TSH, low FT4) or euthyroid (normal values). Thyroid storm is an acute, severe hyperthyroid state, but the underlying hormone pattern here still reflects hyperthyroidism as the condition.

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