Treatment Plan

Initial management:

• Beta-blockers (propranolol) for sympathetic symptoms
• Endocrine team referral for new diagnoses

Secondary care:

• Carbimazole (contraindicated in Graves’ orbitopathy, pregnancy/planning pregnancy within 4-6 months, breastfeeding)
• Propylthiouracil
• Radioactive iodine
• Thyroidectomy: For compression symptoms, multinodular goitre, or when medical therapy is ineffective