The thyroid gland and its function The thyroid gland is divided into two lobes, the right and left, located in the front of the neck under the thyroid cartilage, on both sides of the trachea, and its shape is like a butterfly. The adult thyroid gland weighs about 15-25 grams, and under normal circumstances it is neither clearly visible nor easily palpable. There are usually four parathyroid glands on the back of the two lobes of the thyroid gland, and there are also important structures around the thyroid gland such as the recurrent laryngeal nerve and the superior laryngeal nerve. The thyroid gland has the function of synthesizing, storing and secreting thyroid hormones (T3, T4), and the main role of thyroid hormones is to 1, increase the decomposition of proteins, fats and sugars, and increase the production of calories; 2, to promote the growth and development of the human body. Normal people need a certain amount of thyroid hormones to maintain normal physiological functions. Hyperthyroidism (hyperthyroidism) Hyperthyroidism is caused by abnormally high levels of thyroid hormones in the patient’s blood. According to the cause of the disease can be divided into five categories, among which toxic diffuse goiter (Graves’ disease) is the most common, the age of onset of 20-40 years old, women significantly higher than men. The common clinical manifestations of hyperthyroidism are: 1) enlargement of the thyroid gland, i.e., thickening of the neck; 2) protrusion of both eyes; 3) hypermetabolism, which is characterized by fear of heat and excessive sweating, panic and fatigue, hyperphagia, loss of weight, irritability, and trembling of the hands, etc., which is atypical of the elderly. Diagnosis of hyperthyroidism: Nuclear medicine can provide accurate and reliable diagnosis of hyperthyroidism. For the first diagnosis of patients, a comprehensive examination of thyroid function should be carried out to make an accurate diagnosis. Routine examination for: 1, serum thyroid hormone measurement (including TT3 TT4 TSH FT3 FT4 TG TM) 2, thyroid iodine uptake function measurement 3, thyroid nuclear scanning Hyperthyroidism in the treatment of choice: 1, internal anti-hyperthyroidism medication, 2, surgical treatment, 3, isotope 131 iodine treatment All three treatments are effective, but surgical procedures have been seldom used due to the high risk of trauma; internal anti-hyperthyroidism medication is the most widely used, and the most effective treatment for hyperthyroidism is surgery. Internal anti-hyperthyroidism medication is the most widely used, but only 40-60% of the cure rate can be obtained, and the recurrence rate of hyperthyroidism is very high after stopping the medication. The most common side effects are leukopenia, liver toxicity, and the most serious and life-threatening is granulocyte deficiency. At home and abroad, 131 iodine treatment of hyperthyroidism is considered to be superior to internal and surgical treatment, and it is the ideal treatment of choice. The cure rate of 131 iodine treatment of hyperthyroidism is positively correlated with the size of the 131 iodine treatment dose. The overall cure rate is more than 80%, with an inefficiency rate of 2% – 4% and a relapse rate of 1% – 4%. The best treatment is diffuse goiter with moderate hyperthyroidism. Isotope 131 Radioactive Iodine Treatment of Hyperthyroidism Why is the radioactive isotope 131 iodine able to treat hyperthyroidism? The reason why 131 iodine is able to treat hyperthyroidism is because most of the 131 iodine that enters the body accumulates in the thyroid gland, where it releases beta rays during the decay process. This ray has a range of only 2 millimeters in the thyroid gland, and the energy it releases can destroy the hyperfunctional thyroid tissues and shrink the enlarged thyroid gland, as if it had undergone a surgery. Therefore, 131 iodine treatment for hyperthyroidism is called “bloodless surgery”. Through the measurement of thyroid hormone, thyroid function test, combined with the size of the thyroid gland and the different degrees of hyperthyroidism, the patient can take a certain amount of 131 iodine, which destroys a part of the hyperthyroid tissue and preserves a part of the normal thyroid tissue, so as to achieve the purpose of treating hyperthyroidism. Generally speaking, through 131 iodine treatment, more than 80% of patients with hyperthyroidism symptoms and signs can be quickly controlled and cured. Indications for the treatment of hyperthyroidism with radioisotope 131 iodine 1. Age above 20 years old, with moderate hyperthyroidism. 2.Anti-hyperthyroidism drugs have allergy and can not be used, or long-term treatment is ineffective, or relapse after treatment. 3.Combined heart, liver, kidney and other diseases that are not suitable for surgery, or recurrence after surgery, or those who do not want to have surgery. 4, Certain high-functioning nodules with hyperthyroidism. The safety of radioisotope 131 iodine treatment of hyperthyroidism 131 iodine treatment of hyperthyroidism is different from some other radioactive radiation, in most cases, the radioactive dose received by the thyroid gland is only to cause the destruction of thyroid tissue, occlusion, most of the thyroid cells are killed rather than mutation. Regarding the question of whether 131 iodine treatment of hyperthyroidism induces thyroid nodules, cancer, and genetic complications, reports from decades of follow-up and an extensive review of the literature have not found convincing evidence to date that the treatment increases the risk of nail and other cancers, leukemia, infertility, preterm labor, miscarriage, birth defects, and genetic complications. What is the diagnosis and treatment of hypothyroidism after radioisotope 131 iodine treatment of hyperthyroidism? Hypothyroidism can occur regardless of the method of treatment of hyperthyroidism, so hypothyroidism is not unique to radioisotope 131 iodine treatment. Clinical manifestations of hypothyroidism: fear of cold, low sweat, dry skin, swelling, skin tightness, loss of appetite, bloating, constipation, inflexible joints, muscle pain, drowsiness and mental instability. Diagnosis of hypothyroidism: At present, the diagnosis of hypothyroidism is very accurate and reliable, and it can be diagnosed through the measurement of thyroid hormones (T3, T4, TSH) in venous blood. Treatment of hypothyroidism: As far as isotope 131 iodine treatment of hyperthyroidism is concerned, the incidence of permanent hypothyroidism is increasing at a rate of 1-3% per year, which is not closely related to the dose of radiopharmaceuticals given, but rather to the patient’s sensitivity to the medication or autoimmune reaction. There is currently no way to prevent its occurrence, so the key to curing hyperthyroidism lies in regular checkups for early detection and timely treatment. Alternative treatment is simple, safe, cost-effective and has no side effects.