Hyperthyroidism and thyrotoxicosis — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 5 of 2022

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting hyperthyroidism or thyrotoxicosis or death from hyperthyroidism or thyrotoxicosis with the circumstances of a person's relevant service:

1. (1)
   having iodine excess within the 6 months before the clinical onset of hyperthyroidism or thyrotoxicosis;

   Note: Iodine excess may be due to consuming foods, dietary supplements or medications with a high content of iodine.

   Note: iodine excess is defined in the Schedule 1 - Dictionary.

2. (2)
   being administered an iodine-containing radiographic contrast agent within the 6 months before the clinical onset of hyperthyroidism or thyrotoxicosis;
3. (3)
   taking amiodarone for a continuous period of at least 2 weeks, within the 1 year before the clinical onset of hyperthyroidism or thyrotoxicosis;
4. (4)
   taking a drug from the specified list of drugs within the 6 months before the clinical onset of hyperthyroidism or thyrotoxicosis;

   Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

5. (5)
   taking minocycline for at least the 6 months before the clinical onset of hyperthyroidism or thyrotoxicosis;
6. (6)
   taking a drug containing at least 10 milligrams of iodine daily for a continuous period of at least 4 weeks, within the 6 months before the clinical onset of hyperthyroidism or thyrotoxicosis;
7. (7)
   having a thyroid-stimulating, hormone-secreting pituitary adenoma at the time of the clinical onset of hyperthyroidism or thyrotoxicosis;
8. (8)
   having a chorionic gonadotrophin-secreting neoplasm at the time of the clinical onset of hyperthyroidism or thyrotoxicosis;

   Note: chorionic gonadotrophin-secreting neoplasm is defined in the Schedule 1 - Dictionary.

9. (9)
   having a primary or metastatic neoplasm involving the thyroid gland at the time of the clinical onset of hyperthyroidism or thyrotoxicosis;
10. (10)
    for hyperthyroidism or thyrotoxicosis first presenting as thyrotoxic crisis only, having an acute precipitating event within the 48 hours before the clinical onset of hyperthyroidism or thyrotoxicosis;

    Note: acute precipitating event and thyrotoxic crisis are defined in the Schedule 1 - Dictionary.

11. (11)
    for thyrotoxicosis only: (a) having struma ovarii at the time of the clinical onset of thyrotoxicosis; (b) having metastatic thyroid carcinoma containing functional thyroid tissue at the time of the clinical onset of thyrotoxicosis; (c) having a form of thyroiditis from the specified list of forms of thyroiditis at the time of the clinical onset of thyrotoxicosis; (d) having trauma involving the thyroid gland within the 14 days before the clinical onset of thyrotoxicosis; (e) ingesting excess thyroid hormone in medication, dietary supplements or in food containing thyroid extracts within the 3 months before the clinical onset of thyrotoxicosis;

    Note: struma ovarii is defined in the Schedule 1 - Dictionary.

    Note: specified list of forms of thyroiditis is defined in the Schedule 1 - Dictionary.

    Note: trauma involving the thyroid gland is defined in the Schedule 1 - Dictionary.

12. (12)
    having iodine excess within the 6 months before the clinical worsening of hyperthyroidism or thyrotoxicosis;

    Note: Iodine excess may be due to consuming foods, dietary supplements or medications with a high content of iodine.

    Note: iodine excess is defined in the Schedule 1 - Dictionary.

13. (13)
    being administered an iodine-containing radiographic contrast agent within the 6 months before the clinical worsening of hyperthyroidism or thyrotoxicosis;
14. (14)
    taking amiodarone for a continuous period of at least 2 weeks, within the 1 year before the clinical worsening of hyperthyroidism or thyrotoxicosis;
15. (15)
    taking a drug from the specified list of drugs within the 6 months before the clinical worsening of hyperthyroidism or thyrotoxicosis;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

16. (16)
    taking minocycline for at least the 6 months before the clinical worsening of hyperthyroidism or thyrotoxicosis;
17. (17)
    taking a drug containing at least 10 milligrams of iodine daily for a continuous period of at least 4 weeks, within the 6 months before the clinical worsening of hyperthyroidism or thyrotoxicosis;
18. (18)
    having a thyroid-stimulating, hormone-secreting pituitary adenoma at the time of the clinical worsening of hyperthyroidism or thyrotoxicosis;
19. (19)
    having a chorionic gonadotrophin-secreting neoplasm at the time of the clinical worsening of hyperthyroidism or thyrotoxicosis;

    Note: chorionic gonadotrophin-secreting neoplasm is defined in the Schedule 1 - Dictionary.

20. (20)
    having a primary or metastatic neoplasm involving the thyroid gland at the time of the clinical worsening of hyperthyroidism or thyrotoxicosis;
21. (21)
    for thyrotoxic crisis only, having an acute precipitating event within the 48 hours before that clinical worsening of hyperthyroidism or thyrotoxicosis;

    Note: acute precipitating event and thyrotoxic crisis are defined in the Schedule 1 - Dictionary.

22. (22)
    for thyrotoxicosis only: (a) having struma ovarii at the time of the clinical worsening of thyrotoxicosis; (b) having metastatic thyroid carcinoma containing functional thyroid tissue at the time of the clinical worsening of thyrotoxicosis; (c) having a form of thyroiditis from the specified list of forms of thyroiditis at the time of the clinical worsening of thyrotoxicosis; (d) having trauma involving the thyroid gland within the 14 days before the clinical worsening of thyrotoxicosis; (e) ingesting excess thyroid hormone in medication, dietary supplements or in food containing thyroid extracts within the 3 months before the clinical worsening of thyrotoxicosis;

    Note: struma ovarii is defined in the Schedule 1 - Dictionary.

    Note: specified list of forms of thyroiditis is defined in the Schedule 1 - Dictionary.

    Note: trauma involving the thyroid gland is defined in the Schedule 1 - Dictionary.

23. (23)
    inability to obtain appropriate clinical management for hyperthyroidism or thyrotoxicosis;

Aggravation-only factors: the factors in subsections 9(12) to 9(23) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.