Hyperthyroidism is an abbreviation for hyperthyroidism, which is a clinical syndrome caused by excessive secretion of thyroid hormones due to various etiologies, resulting in increased excitability and hyper-metabolism of the nervous, circulatory and digestive systems. It is a very common endocrine disease. Clinically, patients with hyperthyroidism mainly manifest as panic attacks, fear of heat and sweating, fatigue and weakness, hyperphagia, weight loss, increased frequency of stools or diarrhea, emotional agitation, anxiety, insomnia and nervousness, lack of concentration, slight tremor when extending the tongue or holding the hands forward, scanty menstruation or even amenorrhea in women, and impotence in men. The cause of hyperthyroidism in Graves’ disease is still unclear, but it may be due to the production of anti-TSH receptor antibodies (TRAb) caused by genetics, infection, immunity and other factors, resulting in excessive synthesis of thyroid hormone, which “overflows” into the blood when it exceeds the storage capacity of the thyroid follicles. When it exceeds the storage capacity of the thyroid follicles, it “overflows” into the blood, and the level of thyroid hormone in the blood rises, leading to hyperthyroidism. Other disorders in which excessive hormone production causes hyperthyroidism include toxic multinodular goiter, autonomously high-functioning adenoma of the thyroid, and pituitary hyperthyroidism. It is important to note that some patients clinically present with symptoms of hyperthyroidism, but the cause is a transient hyperthyroidism due to destruction of the thyroid follicles by inflammation (e.g., subacute thyroiditis, Hashimoto’s thyroiditis, etc.) and the excessive release of stored thyroid hormones in the follicles, called destructive thyrotoxicosis. T3, T4, FT3, FT4 are elevated while TSH is significantly decreased to clarify hyperthyroidism. 2. Antibody test: to clarify which kind of hyperthyroidism is present. TPOAb and TGAb are destructive antibodies that destroy the thyroid follicles, resulting in transient hyperthyroidism due to excessive release of thyroid hormones. (A high level of these two antibodies means that there is a Hashimoto factor and a puncture is required to confirm the diagnosis of Hashimoto’s thyroiditis.) If both excitatory and destructive antibodies are present, TRAb is predominant and it is still Graves’ hyperthyroidism. 3. Ultrasound of the thyroid gland: clarify the presence of enlargement and nodules in the thyroid gland. 4. 131I uptake rate of the thyroid gland: 131I uptake rate is increased in Graves’ disease and decreased in Hashimoto’s thyroiditis. In initial hyperthyroidism, when TRAb cannot be measured, an increased 131I uptake rate can clearly indicate Graves’ hyperthyroidism with excessive thyroid hormone synthesis. In addition, in patients with nodular hyperthyroidism, isotope ECT scan can exclude hyperthyroidism caused by high-functioning adenoma. After a clear diagnosis of Graves’ hyperthyroidism, besides medication, daily lifestyle and diet also play a vital role in the regression of the disease, therefore, we summarize the precautions for patients with Graves’ hyperthyroidism as the following four points. Iodine is the main raw material for the production of thyroid hormones, and excessive intake of iodine can lead to aggravation or prolongation of hyperthyroidism. Absolutely no iodine we should do: 1, avoid all seafood, try to eat non-iodized salt. The daily intake of iodine for normal people is 150 micrograms/day, while for hyperthyroidism it should be less than 50 micrograms/day. We classify iodine-containing foods into three classes. The first class contains thousands to tens of thousands of micrograms of iodine per 100 grams, including: kelp (kombu), nori (seaweed), moss strips, jellyfish, etc. The second class contains hundreds to thousands of micrograms of iodine per 100 grams, including: sea crabs, shellfish from the sea, etc. The third category contains more than tens to hundreds of micrograms of iodine per hundred grams, including: sea fish, sea shrimp, etc.; and the iodized salt generally contains about 20-30 micrograms per gram of salt. Therefore, all seafood is highly iodized food relative to hyperthyroidism patients, and iodized salt should be avoided as much as possible. 2. Reduce the chance of eating out. The salt used in restaurants is usually iodized salt, and in the same frying pan, we cannot guarantee that the last customer ordered is not seafood, and a large amount of iodine is inevitably mixed into the food during the cooking process. 3. Avoid using medicines and cosmetics containing iodine. Drugs include: amiodarone, an anti-arrhythmia drug; contrast agent for CT enhancement; iodine for disinfection; iodine-containing vitamin tablets (including Sun Cun, Jin Shier Kang, etc.); cosmetics include: face wash, shampoo, mask, foot bath powder, etc. containing seaweed ingredients. 4. Avoid traveling to coastal cities. The specialty of coastal cities is seafood, and it is impossible to avoid the intake of a large amount of iodine in the course of tourism dining, and it can even be said that even the sea breeze will have a lot of iodine components. In short, we should try to avoid excessive intake of iodine in our life (in terms of eating, using and playing) and do “absolute avoidance of iodine”. When hyperthyroidism occurs after pregnancy, as long as the TRAb is positive, iodine should be absolutely avoided; Graves’ disease hyperthyroidism is a result of desperate iodine intake and desperate production of thyroid hormones, resulting in an excess of hormones, so iodine (raw materials) should not be added. The fetal thyroid gland has not yet developed and what it really needs is the mother’s FT4 (finished product). As long as the mother’s nail function is normal and Ft4 is sufficient, the fetus will not be iodine deficient. Even if the thyroid hormone level of the hyperthyroid mother decreases later due to the effect of hyperthyroidism medication, the supplement should be eugenol, etc. (L-T4), which is the finished product, not the raw iodine. In terms of diet hyperthyroidism patients should also pay attention to: 1. Stimulating foods (such as: spicy foods, coffee, strong tea, etc.): hyperthyroidism patients themselves can have symptoms of sympathetic excitement such as panic, fear of heat, mental excitement, insomnia, etc. Stimulating foods can lead to the aggravation of the above symptoms and should be avoided before the thyroid function is fully controlled. In addition, certain cold medicines, such as Tylenol. The instructions of the medicine, such as Tylenol, are written to “use with caution in patients with hyperthyroidism”, that is because these drugs contain pseudoephedrine, which can lead to an accelerated heart rate, and can be taken after the control of thyroid function. Calcium: High metabolism is one of the characteristics of hyperthyroidism. Therefore, middle-aged and elderly patients with osteoporosis should pay attention to calcium and vitamin D supplementation. Vitamins: Hyperthyroid patients are prone to vitamin deficiency, and the application of anti-thyroid drugs in the treatment of hyperthyroidism itself causes a decrease in white blood cells, which also requires vitamin supplementation. Avoid infections: The low total white blood cell count and granulocyte count in hyperthyroid patients can easily lead to infections. If infection occurs, it may cause the relapse or aggravation of controlled hyperthyroidism, or even the emergence of hyperthyroid crisis. Studies have shown that infections can increase TRAb and prolong the course of hyperthyroidism. Therefore, it is important to learn to prevent all kinds of infections, and once the signs of infections are detected, they should be treated early, and it is not recommended to rely on one’s own resistance to resist. 3. Pay attention to rest Patients with hyperthyroidism should not stay up late and engage in strenuous activities such as long-distance running, swimming and mountain climbing; those who are seriously ill should take rest or even rest in bed. In addition, some patients with hyperthyroidism may have protruding eyes, which paralyze the extra-ocular muscles and cause visual fatigue and eye swelling. After reading books and newspapers for a long time, especially after watching TV, the eyes often feel swollen and painful. Therefore, patients with this disease should pay attention to reducing eye irritation and visual fatigue. At present, antithyroid drugs are still the basic treatment for Graves’ hyperthyroidism. They do not destroy the follicular structure of the thyroid gland, are safe and effective, have reversible effects, and do not cause permanent hypothyroidism. However, drug therapy is a long-term process, with an average treatment time of two years. In particular, regular follow-up visits are needed to adjust the drug dosage within six months after the onset of the disease, and some patients may experience liver function damage and a decrease in white blood cells, so regular blood tests and liver functions are needed at the early stage of hyperthyroidism to understand whether there are any drug side effects. This requires the full cooperation of patients, regular treatment, and taking medication as prescribed by the doctor in order to achieve the expected therapeutic effect.