Hyperthyroidism, or hyperthyroidism for short. The main clinical symptoms of hyperthyroidism include enlargement of the thyroid gland, hyperphagia, weight loss, and tachycardia. The main clinical symptoms of hyperthyroidism include enlargement of the thyroid gland, increased appetite, weight loss, rapid heartbeat, agitation, fear of heat, sweating and hand tremors. Currently, the common methods of treatment for hyperthyroidism include medication, surgery and radioactive iodine therapy.
Internal anti-thyroid medication mainly inhibits the synthesis of thyroid hormones. The disadvantage of this treatment is the long duration of treatment, at least one year of regular medication, and the high relapse rate after stopping the medication, which can be more than 50 %. Some patients also have allergic reactions or leukopenia, hypothyroidism and impaired liver function. Many patients need to be hospitalized because of these problems, and patients with leukopenia need to be injected into the critical care unit, etc. Du Jianqiang, Department of Internal Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine
Surgery is also commonly used, with the disadvantage of recurrence and a high recurrence rate (30%), especially in diffusely enlarged hyperthyroidism. Scarring, hypothyroidism, damaged parathyroid glands, damaged retrograde laryngeal nerve, damaged superior laryngeal nerve, laryngeal edema, thyroid crisis, infection. people over 40 years old know a famous actress named Wang Xiaotang who underwent surgery after suffering from hyperthyroidism, which resulted in loss of voice after surgery and had a great impact on her career development.
The principle of radioactive 131I treatment is that the thyroid gland has the function of highly selective iodine uptake, and the half-life of 131I is 8.04 days. 131I is taken up by the thyroid gland, and the beta rays emitted during decay can be completely absorbed by the thyroid tissue due to its low energy and short range (about 2-3mm), and rarely damage the surrounding tissues, which can cause the thyroid tissue to be damaged by the concentrated exposure of beta rays, thus It can reduce the formation of thyroid hormone and achieve the purpose of treating hyperthyroidism.
Since this method has the advantages of simplicity, safety, economy, good efficacy and low recurrence rate, it has become the preferred treatment for hyperthyroidism in developed countries.
Since the general public does not have much knowledge about nuclear medicine, they are afraid of nuclear in their daily life, especially due to the influence of some news reports without health background explanation, such as the Fukushima nuclear accident in Japan and the Chernobyl nuclear accident in the former Soviet Union, resulting in many hyperthyroid patients being “afraid of talking about nuclear”. The main concerns include hypothyroidism, carcinogenic effects, and effects on fertility (genetics). After decades of clinical practice, it has been proved that these concerns have been eliminated. According to a large number of statistics at home and abroad, no increase in the incidence of leukemia and thyroid malignancies has been found, and the rate of fetal malformations does not exceed the natural rate.
Hypothyroidism is also an important issue of concern for the majority of patients. In fact, hypothyroidism is not unique to 131I treatment. Hypothyroidism can occur after medical and surgical treatment, and even spontaneous hypothyroidism can occur without any therapeutic measures for hyperthyroidism. Therefore, it is now believed that hypothyroidism is a natural progression of the course of hyperthyroidism.
Patients should also have a proper understanding of the problem of hypothyroidism after hyperthyroidism treatment. Since hypothyroidism is a regression of the course of hyperthyroidism, we need to face it inevitably. The sister chose 131I treatment after her hyperthyroidism was cured, but she got hypothyroidism and needed to take thyroxine for a long time to maintain her thyroid function. Later, my sister also had hyperthyroidism. In view of my sister’s experience of developing hypothyroidism after treatment with 131I, my sister firmly refused 131I treatment, but she was afraid of the side effects of drug and surgical treatment, so she missed the timing of treatment, and later was admitted to the neurology department for treatment of hyperthyroid heart disease (hyperthyroid heart disease) due to thrombosis and brain infarction caused by dislodged blood clots. He then regretted his choice and asked for 131I treatment on his own initiative. This is a very painful lesson. From the above examples, it is easy to see how we should make our own choices when facing hyperthyroidism.