US: Thyroid Disease: Diagnostic Challenges

Activity Title

Thyroid Disease: Diagnostic Challenges

Statement of Need/Program Overview

This educational activity focuses on the problems associated with the diagnosis of autoimmune-induced hyperthyroidism or Graves’ disease (GD). Gail Devers, an elite track and field athlete and Olympic gold medalist, describes her experience prior to when she was diagnosed with GD when she was training for the Olympics. She describes symptoms of headaches, fatigue, weight loss, muscle pain, abnormal menstrual periods, and other symptoms of general discomfort. She saw several physicians, including a gynecologist and general practitioner, but her symptoms and clinical signs were dismissed and her diagnosis was delayed for several years. The importance of taking a complete history and focusing on the patient’s concerns is emphasized. The value of seeing a nurse practitioner or primary care physician who knows the patient and may have more time to listen to the patient is discussed. The differential diagnosis of Ms. Devers condition is discussed with an emphasis on the possibility of hyperthyroidism. Once hyperthyroidism is diagnosed with low serum thyrotropin (TSH) and GD is confirmed by measuring the specific serological biomarker TSH receptor antibodies (TSH-R-Ab), it is important to review with the patient the nature of the disease, the treatment plan, and the prognosis. Advances in the diagnosis of GD with an emphasis on the importance of measuring anti TSH-R-Ab is emphasized. Risk factors for GD and other autoimmune diseases, including genetic, environmental, and behavioral are discussed. Ms. Devers emphasizes the importance of self-advocacy when interacting medical providers.

Target Audience

This activity is intended for medical professionals who have a clinical interest in thyroid disorders as seen in the following medical specialties: endocrinology, primary care (IM, FP, GP), obstetrics/gynecology, cardiology, pediatrics, laboratory medicine, nuclear medicine, ophthalmology, neurology, psychiatry, and sleep medicine.

Educational Objectives

After completing this activity, the participant should be better able to:

Explain the diagnostic challenges associated with Graves’ Disease.
Describe the preferred diagnostic methodologies for Graves’ Disease.
Summarize the risk factors associated with undiagnosed and/or untreated Graves’ Disease.
Discuss the need for increased awareness of possible thyroid disease as well as improved communication between primary care and endocrinology clinicians in the diagnosis, treatment and management of patients with thyroid disease.

Faculty

George J. Kahaly, MD, PhD
Professor of Medicine and Endocrinology / Metabolism
Johannes Gutenberg University (JGU) Medical Center
Mainz, Germany

Shannon K. Idzik, DNP
Professor, Organizational Systems and Adult Health
Associate Dean for the DNP Program
University of Maryland School of Nursing
Baltimore, Maryland

Featured Guest Speaker

Gail Devers
Three-time Olympic Gold Medalist
Graves’ Disease Patient & Patient Advocate

CME Provider Accreditation Statement

This activity is provided by Dane Garvin Ltd.

Physician Accreditation Statement - CME

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the providership of McLean Hospital. McLean Hospital is accredited by the ACCME to provide continuing medical education for physicians.

Physician Credit Designation - CME

McLean Hospital designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Academy of Family Physicians (AAFP) Accreditation

The AAFP has reviewed Thyroid Disease: Diagnostic Challenges and deemed it acceptable for up to 1.00 Enduring Materials, Self-Study AAFP Prescribed credit(s). Term of Approval is from 05/15/2025 to 05/15/2026. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Psychology Accreditation Statement

This program is co-sponsored by McLean Hospital and Dane Garvin Ltd. McLean Hospital is approved by the American Psychological Association to sponsor continuing education for psychologists. McLean Hospital maintains responsibility for this program and its content. This offering meets the criteria for 1.0 C.E. hour for psychologists.

Nursing Continuing Education

This program meets the requirements of the Massachusetts Board of Registration in Nursing (244 CMR 5.00) for 1.0 contact hour of nursing continuing education credit. Advance practice nurses, please note: Educational activities which meet the requirements of the ACCME (such as this activity) count towards 50% of the nursing requirement for ANCC accreditation.

McLean Hospital Contact Information

For information about the accreditation of this program, please contact Marjorie Overhiser at 617-855-3151 or moverhiser@mgb.org.

Educational Activity Agenda

Educational Presentation: 60 minutes
Post Test and Evaluation: 5 minutes
Total Activity: 65 minutes

Term Offering

This activity was released on May 15, 2025 and is valid for one year. Requests for credit must be made no later than May 15, 2026.

Instructions to Receive Credit

In order to receive credit, participants must complete all of the course lessons. Participants must also score at least a 70% on each chapter quiz. Upon completion of lessons and quizzes, you must also complete the evaluation form. Your certificate will be available to download upon completion of the evaluation.

System Requirements

To view this educational activity, you will need a web browser with JavaScript and either Flash or HTML5 enabled. Nearly all modern web browsers will work.

Fee Information

There is no fee for this educational activity.

Disclosure of Relevant Financial Relationships

McLean Hospital adheres to the policies and guidelines, including the Standards for Integrity and Independence in Accredited CE, set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous. All persons in a position to control the content of an accredited continuing education program provided by McLean Hospital are required to disclose all financial relationships with any ineligible company within the past 24 months to McLean Hospital. All financial relationships reported are identified as relevant and mitigated by McLean Hospital in accordance with the Standards for Integrity and Independence in Accredited CE in advance of delivery of the activity to learners. The content of this activity was vetted by McLean Hospital to assure objectivity and that the activity is free of commercial bias.

All relevant financial relationships have been mitigated.

Disclosure Information

In accord with the disclosure policy of McLean Hospital as well as guidelines set forth by the Accreditation Council on Continuing Medical Education, all people in control of educational content, including speakers, course directors, planners, and reviewers, have been asked to disclose all financial relationships with ineligible companies for the past 24 months, as defined below:

Ineligible Companies
The ACCME defines an “Ineligible company” as “those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.” For more information, visit accme.org/standards.

Faculty Disclosures

The faculty disclosed the following financial relationships with ineligible companies related to the content of this educational activity.

Planners and Reviewers

The planners and reviewers of this activity have reported that they have no relevant financial relationships to disclose.

Disclosure of Unlabeled Use

Presenters discussing any drug/product use that is off label, will disclose that the use or indication in question is not currently approved by the FDA.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

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Grant Support Statement

This activity has received no commercial support.

Policy on Privacy and Confidentiality

McLean Hospital protects the privacy of personal and other information regarding participants, educational partners, and joint sponsors. McLean Hospital and our joint sponsors will not release personally identifiable information to a third party without the individual's consent, except such information as is required for reporting purposes to the appropriate accrediting agency.

McLean Hospital and Dane Garvin Ltd. maintain physical, electronic and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.