Full history and examination to assess disease severity and comorbidities including age, smoking and family history, dietary history and drug history, HR, BP, weight, and assessment of the neck and ophthalmopathy.

Assessment of the neck should include examination of the goiter. A palpably dominant nodule should indicate the need for imaging to exclude a solitary toxic adenoma. A bruit on auscultation is pathognomonic of Graves’ disease.

Biochemical evaluation:

Imaging modalities used in the investigation of thyrotoxicosis depend on the likely treatment plan. In many instances imaging is unnecessary.