Hyperthyroidism
What the FAA's documents say about hyperthyroidism, in plain words, with the FAA's own words one press away.
- The hyperthyroidism AASI says the examiner must defer to the AMCD or Region if the applicant has developed hypothyroidism, which has its own page.
Short version
The FAA's table has one row for it.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row AAny history | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Hyperthyroidism
- Row A · Special Issuance
Any history of hyperthyroidism. The examiner submits the listed items for FAA review, defers, submits the information to the FAA for a possible Special Issuance, and annotates the elements or findings in Block 60.
A. Any history … Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance Annotate (elements or findings) in Block 60.
The FAA pathways for hyperthyroidism
Which exam
Your plan
Step 1: What to submit for FAA review
The progress note, lab and reports the table lists.One question insideProgress note
Within 90 days before the examA current, detailed progress note from a clinic visit with your treating physician (family medicine, internal medicine, endocrinology), no more than 90 days before the exam.
It should include
- A summary of the history of the condition or diagnosis
- Current medications, dosages, and side effects (if any)
- Clinical exam findings
- Results of any testing performed
- Diagnosis
- Assessment and plan (prognosis)
- Follow-up
Lab results
Within 90 days before the examLab performed no more than 90 days before the exam.
To include
- Thyroid stimulating hormone (TSH)
- Any other lab already performed by your treating physician, such as T3 or free T4
Imaging reports
Copies of any imaging reports (MRI, CT, ultrasound, X-ray) already performed.
Other testing
Any other testing your treating physician deems clinically necessary.
Thyroidectomy reports
The operative report, the History and Physical, and the Discharge summary.
Show the FAA's words: What to submit for FAA review
1. A current, detailed Clinical Progress Note generated from a clinic visit with their treating physician (family medicine, internal medicine, endocrinology) no more than 90 days before the AME exam.
FAA source: Hyperthyroidism Disposition Table. FAA date 29 July 2026; checked by Crosscheck 14 October 2026.
It should include a summary of the history of the condition or diagnosis; current medications, dosages, and side effects (if any); clinical exam findings; results of any testing performed; diagnosis; assessment and plan (prognosis); and follow-up.
FAA source: Hyperthyroidism Disposition Table. FAA date 29 July 2026; checked by Crosscheck 14 October 2026.
2. Lab: Performed no more than 90 days before the AME exam to include
Thyroid Stimulating Hormone (TSH), and
Any other lab already performed (e.g. T3, Free T4) by the treating physician.
FAA source: Hyperthyroidism Disposition Table. FAA date 29 July 2026; checked by Crosscheck 14 October 2026.
3. Imaging: Copies of any imaging reports (MRI, CT, ultrasound, X-ray) already performed.
FAA source: Hyperthyroidism Disposition Table. FAA date 29 July 2026; checked by Crosscheck 14 October 2026.
4. Any other testing deemed clinically necessary by the treating physician.
FAA source: Hyperthyroidism Disposition Table. FAA date 29 July 2026; checked by Crosscheck 14 October 2026.
5. If previous thyroidectomy, submit operative report, History and Physical, and Discharge summary.
FAA source: Hyperthyroidism Disposition Table. FAA date 29 July 2026; checked by Crosscheck 14 October 2026.
What the examiner checks
Row ADefers to the FAASpecial Issuance
The examiner submits the listed items for FAA review, defers, submits the information to the FAA for a possible Special Issuance, and annotates the elements or findings in Block 60.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Special Issuance
Any history of hyperthyroidism. The examiner submits the listed items for FAA review, defers, submits the information to the FAA for a possible Special Issuance, and annotates the elements or findings in Block 60.
A. Any history … Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance Annotate (elements or findings) in Block 60.
If the examiner defersSpecial Issuance
The table's only row is Any history, and the table marks it DEFER.
What the FAA lists to send
- Item 1. A current, detailed clinical progress note generated from a clinic visit with the treating physician (family medicine, internal medicine, endocrinology) no more than 90 days before the exam. The table says it should include a summary of the history of the condition or diagnosis; current medications, dosages, and side effects (if any); clinical exam findings; results of any testing performed; diagnosis; assessment and plan (prognosis); and follow-up.
- Item 2. Lab performed no more than 90 days before the exam, to include a thyroid stimulating hormone (TSH) and any other lab already performed by the treating physician (for example T3 or free T4).
- Item 3. Copies of any imaging reports (MRI, CT, ultrasound, X-ray) already performed.
- Item 4. Any other testing deemed clinically necessary by the treating physician.
- Item 5. If there was a previous thyroidectomy, the operative report, the History and Physical, and the Discharge summary.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table's only row is Any history, and the table marks it DEFER.
A. Any history … DEFER Submit the information to the FAA for a possible Special Issuance
What the FAA lists to send
- Item 1
A current, detailed clinical progress note generated from a clinic visit with the treating physician (family medicine, internal medicine, endocrinology) no more than 90 days before the exam. The table says it should include a summary of the history of the condition or diagnosis; current medications, dosages, and side effects (if any); clinical exam findings; results of any testing performed; diagnosis; assessment and plan (prognosis); and follow-up.
1. A current, detailed Clinical Progress Note generated from a clinic visit with their treating physician (family medicine, internal medicine, endocrinology) no more than 90 days before the AME exam. It should include a summary of the history of the condition or diagnosis; current medications, dosages, and side effects (if any); clinical exam findings; results of any testing performed; diagnosis; assessment and plan (prognosis); and follow-up.
- Item 2
Lab performed no more than 90 days before the exam, to include a thyroid stimulating hormone (TSH) and any other lab already performed by the treating physician (for example T3 or free T4).
2. Lab: Performed no more than 90 days before the AME exam to include … Thyroid Stimulating Hormone (TSH), and … Any other lab already performed (e.g. T3, Free T4) by the treating physician.
- Item 3
Copies of any imaging reports (MRI, CT, ultrasound, X-ray) already performed.
3. Imaging: Copies of any imaging reports (MRI, CT, ultrasound, X-ray) already performed.
- Item 4
Any other testing deemed clinically necessary by the treating physician.
4. Any other testing deemed clinically necessary by the treating physician.
- Item 5
If there was a previous thyroidectomy, the operative report, the History and Physical, and the Discharge summary.
5. If previous thyroidectomy, submit operative report, History and Physical, and Discharge summary.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workGood to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
A thyroidectomy adds three reports
If there was a previous thyroidectomy, the table asks for the operative report, the History and Physical, and the Discharge summary.
Show the FAA's words: good to know, 2
5. If previous thyroidectomy, submit operative report, History and Physical, and Discharge summary.
Which treating physician writes the note
The table names the treating physician as family medicine, internal medicine or endocrinology, and the visit no more than 90 days before the exam.
Show the FAA's words: good to know, 3
1. A current, detailed Clinical Progress Note generated from a clinic visit with their treating physician (family medicine, internal medicine, endocrinology) no more than 90 days before the AME exam.
Three reasons a reissue goes back to the FAA
Under an Authorization, the AASI says the examiner must defer if the applicant has developed hypothyroidism, the thyroid function studies are elevated, suggesting inadequate treatment, or the applicant developed an associated illness, such as dysrhythmia.
Show the FAA's words: good to know, 4
The Examiner must defer to the AMCD or Region if: … The applicant has developed hypothyroidism; or … The thyroid function studies are elevated, suggesting inadequate treatment; or … The applicant developed an associated illness, such as dysrhythmia.
The first AASI is deferred to the FAA
When this is a first-time application for this AASI and the applicant has all the requisite medical information for a determination, the examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.
Show the FAA's words: good to know, 5
If this is a first-time application for an AASI for the above disease/condition, and the applicant has all the requisite medical information necessary for a determination, the Examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
- Hyperthyroidism Disposition TableOpen to print: Hyperthyroidism Disposition Table, a PDF at the FAA, in a new tab
Special Issuance
- Open to print: AASI – Hyperthyroidism, a page at the FAA, in a new tab
- Open at the FAA: Hypothyroidism (Item 48, endocrine), a page at the FAA, in a new tab
- Open at the FAA: Pilot Information – What a Detailed Clinical Progress Note must contain, a PDF at the FAA, in a new tab
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.