This article is original, if you want to reproduce it, please contact me and ask for permission. Some time ago, a colleague from our hospital came to see me, saying that his daughter was 25 years old, because she recently felt panic, rapid heart rate, some fear of heat sweating, hand trembling symptoms, check the electrocardiogram suggests tachycardia, did a thyroid function test: T3, T4, FT3, FT4 have mildly elevated, TSH significantly decreased. A hospital doctor suggested taking tabazol for hyperthyroidism. However, I was worried about the side effects of the medication, so I came to see me for consultation. The patient was not married and had no recent symptoms of anterior neck pain or discomfort, no obvious goiter, proptosis, etc. She had mild weight loss and stools once or twice a day. I recommended further tests and checked thyroglobulin antibodies, thyroid peroxidase antibodies, thyrotropin receptor antibodies were negative, blood sedimentation was not high, and thyroid ultrasound was not significantly abnormal. From the patient’s thyroid function tests, hyperthyroidism can be diagnosed, but the etiology of the disease is still unclear, which requires some analysis. Xia Chengdong, Department of Endocrinology, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine, refers to thyrotoxicosis as an increase in thyroid hormone levels due to any cause, i.e., elevated T3, T4, FT3, FT4 on thyroid labs; a syndrome caused by excessive thyroid hormones in the blood circulation, resulting in increased excitability and hyper-metabolism of the body’s nervous, circulatory, and digestive systems. Hyperthyroidism is a syndrome caused by an excess of thyroid hormones in the bloodstream, resulting in increased excitability and hypermetabolism of the nervous, circulatory and digestive systems. The diseases that cause hyperthyroidism include Graves’ disease (toxic diffuse goiter, commonly known as hyperthyroidism), toxic nodular goiter, toxic thyroid adenoma, thyroiditis (subacute thyroiditis, Hashimoto’s disease, postpartum thyroiditis), Hashimoto’s thyroiditis with thyrotoxicosis, iodine hyperthyroidism, artificial (exogenous) thyrotoxicosis, neonatal hyperthyroidism, gestational thyrotoxicosis, and pituitary hyperthyroidism (secretory hyperthyroidism). pituitary hyperthyroidism (TSH-secreting pituitary tumor), choriocarcinoma or chylothorax (ectopic TSH syndrome), ovarian goiter, and toxic thyroid cancer. The most common is Graves’ disease, which accounts for about 80% or more of all hyperthyroidism, followed by toxic nodular goiter and toxic thyroid adenoma. However, because the prognosis and treatment of various causes of hyperthyroidism vary, it is important to identify the cause of hyperthyroidism. Returning to the above case, if one chooses to use tapazole as an antithyroid drug, there are three questions: First, is the diagnosis correct and is it necessary to use the drug for treatment? Second, the standard course of anti-thyroid medication with tapazole is one and a half to two years, which is a relatively long period of time. Third, during the application of tapazole, it is necessary to monitor the side effects of the drug, such as allergic reactions, changes in white blood cells, liver function, etc. The patient had no obvious symptoms such as goiter, proptosis, pretibial mucinous edema, no obvious abnormalities in thyroid ultrasound, and negative thyroglobulin antibodies, thyroid peroxidase antibodies, and thyrotropin receptor antibodies, all of which were clearly inconsistent with typical Graves’ disease (toxic diffuse goiter, commonly known as hyperthyroidism), and there were still some doubts about the diagnosis. Therefore, I carefully questioned the patient’s father and learned that the patient, as a young woman, was “thin as beautiful” and was worried about her weight, so she bought a weight loss drug from an informal source and took it by herself. Upon hearing this, I thought that the physiological role of thyroid hormone is to regulate the body’s growth and development, energy and material metabolism, heat production and body temperature regulation, etc. Some unscrupulous businessmen may take advantage of the low price of thyroid tablets and their effect on the body’s growth and development to apply thyroid tablets illegally to lose weight, which may result in unsatisfactory weight loss and artificial (exogenous) hyperthyroidism. So I instructed the patient to stop using the so-called weight loss drugs, to pay proper attention to rest and avoid strenuous activities because of tachycardia, and to apply the drug betalactam for a short period of time to slow down the heart rate and improve the symptoms of heartburn. After a period of time, the patient had no more symptoms and stopped taking the medication. Two months later, the patient’s blood was drawn and retested, and all indicators were normal. Combined with this case, the inspiration for us is: firstly, it is very necessary to carry out etiological identification for hyperthyroidism labs, because the treatment and prognosis of hyperthyroidism caused by various etiologies are different, and there are even some hyperthyroidism that do not need treatment; secondly, it is important to be legally compliant before carrying out any drug treatment, preferably under the guidance of a specialist. Secondly, any medication must be legal and compliant before treatment, and it is best to be guided by a specialist.