Factitious hyperthyroidism requires a two-pronged approach: rapid control of adrenergic symptoms in symptomatic patients and targeted pharmacological therapy to restore normal thyroid biochemistry.

Treatment Approach — Overview

Symptomatic patients are managed with beta blockers to control adrenergic manifestations; patients who cannot tolerate beta blockers have alternative pharmacological options available. A specific first-line anti-thyroid drug is recommended for all patients requiring pharmacological intervention — the full regimen, selection criteria, and dosing algorithm are in the complete protocol.

Clinical Goal

The treatment target is a biochemically euthyroid state, typically achievable within 4–8 weeks of initiating anti-thyroid drug therapy, though the timeline varies with disease severity and compliance.

References

DOI: 10.1089/thy.2016.0229

Beta blockers should be given to all symptomatic patients with hyperthyroidism.
In patients who do not tolerate or are not candidates for use of beta blockers, calcium-channel blockers, both verapamil and diltiazem, can be used.
Carbimazole is the recommended first line of anti-thyroid medication in all patients who are treated with anti-thyroid drug therapy.
Most patients will be biochemically euthyroid within 4–8 weeks, although the timeline will depend on disease severity, anti-thyroid drug dose and compliance.

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Treatment of Factitious Hyperthyroidism: Controlling Adrenergic Symptoms and Achieving Biochemical Euthyroid State

References