---
name: thyrotoxicosis-patterns
description: Recognize the common pattern of thyrotoxicosis and organize the focused differential and testing plan. Use when symptoms include weight loss, tremor, heat intolerance, palpitations, anxiety, diarrhea, or proximal weakness.
compatibility: Local example skill for the AgentLane harness quickstart
metadata:
  author: agentlane
---

# Thyrotoxicosis Patterns

Use this skill when a clinician suspects excess thyroid hormone as a unifying
explanation for a symptom cluster.

Approach:

1. A combination of weight loss, tremor, heat intolerance, tachycardia,
   palpitations, anxiety, or frequent stools should raise concern for
   thyrotoxicosis.
2. Common etiologies include Graves disease, toxic multinodular goiter, toxic
   adenoma, and thyroiditis. Distinguish them with exam clues, duration, and
   targeted testing.
3. Focused next tests are TSH first, then free T4 and often total or free T3 if
   TSH is suppressed. Consider thyroid-stimulating immunoglobulins or receptor
   antibodies when Graves disease is likely.
4. If the case includes severe tachyarrhythmia, agitation, fever, heart failure,
   or altered mental status, note concern for thyroid storm and escalate.
5. When answering, give the likely syndrome, the top etiologies to separate, and
   the most useful next laboratory or imaging steps.

Avoid overstating the diagnosis when endocrine confirmation is still pending.