Hyperthyroidism commonly presents with metabolic and cardiovascular symptoms, but urinary and especially faecal incontinence are rarely recognised manifestations. We report a 50-year-old woman with diabetes, hypertension and previous stroke who presented with progressive urinary and faecal incontinence for six months. Extensive gastrointestinal and urological investigations were unremarkable. Clinical examination revealed tachycardia and a thyroid swelling. Thyroid function tests confirmed thyrotoxicosis. The patient was treated with carbimazole, resulting in biochemical improvement and marked resolution of incontinence symptoms. This case highlights that thyroid dysfunction should be considered in patients with diabetes presenting with unexplained urinary or faecal incontinence, as recognition can prevent unnecessary investigations and lead to reversible outcomes.

Keywords: Multinodular goitre; Hyperthyroidism; Graves’ disease; Incontinence