Hyperthyroidism (hyperthyroidism) is a clinical syndrome caused by excessive secretion of thyroid hormones due to multiple etiologies. Graves’ disease (GD), also known as toxic diffuse goiter, is an organ-specific autoimmune disease with increased secretion of thyroid hormones. In addition to goiter and hypermetabolic syndrome, clinical manifestations include proptosis and, less commonly, anterior tibial mucinous edema or thickened fingertips. Graves’ disease is more common in young and middle-aged women between 20 and 40 years of age, with a male to female ratio of 1:4-6. It can develop in all age groups, mostly with a chronic onset, and a few acutely after stress such as trauma or infection. Clinical manifestations vary, with typical manifestations including hypermetabolic syndrome, goiter, and ophthalmic signs. In elderly and pediatric patients, the clinical manifestations are often atypical. Typical clinical symptoms include: 1. Hypothyroidism syndrome 1. Hypermetabolic syndrome Due to excessive secretion of thyroid hormones and increased sympathetic excitability, it promotes material metabolism and accelerates oxidation, resulting in a significant increase in heat production and heat loss. Patients often have fatigue and weakness, fear of heat and sweating, warm and moist skin, rapid weight loss and hypothermia, and may have high fever in critical conditions. 2. Mental and neurological symptoms: They are hypersensitivity, verbosity, nervousness and anxiety, restlessness, insomnia, disbelief and memory loss. Sometimes there are fantasies, and even manifest sub-mania or schizophrenia. Occasionally manifest as oligophrenia and depression, indifference, also may have hand, eyelid and tongue tremor, tendon reflex hyperactivity. 3. Cardiovascular system symptoms: palpitations, chest tightness, shortness of breath, and in severe cases, hyperthyroid heart disease may occur. Signs may include: tachycardia, rapid heart rate at rest and during sleep; hyperacusis of the first heart sound in the apical region, often with class I-II systolic murmur; arrhythmias, especially atrial precontraction, but also ventricular or junctional; paroxysmal or persistent atrial fibrillation or atrial flutter, occasionally atrioventricular block; enlarged heart, prone to heart failure when the heart load increases; rising systolic blood pressure, falling diastolic blood pressure, increasing pulse pressure difference. Systolic pressure increases, diastolic pressure decreases, and pulse pressure difference increases. 4, digestive system symptoms: often have hyperphagia, overeating and wasting. Older patients may have loss of appetite and anorexia. Due to accelerated gastrointestinal motility, digestion and malabsorption and increased number of discharge, containing more undigested food. Heavy patients may have large liver and liver function abnormalities, and occasionally jaundice. 5, musculoskeletal system symptoms: some patients have hyperthyroidism, muscle weakness and muscle atrophy, mostly seen in the scapular and pelvic girdle muscle groups. Periodic paralysis is mostly seen in young male patients, and the cause is unknown. Blood potassium is reduced during seizures, but urinary potassium is not high, probably due to potassium transfer to the liver and myocytes. 6. Reproductive and endocrine system: women often have decreased menstruation or amenorrhea. Males have impotence, occasional breast development, and increased blood prolactin and estrogen. Gonadal hormone metabolism is accelerated, and sex hormone binding globulin is often increased. The half-life of cortisol is shortened. 7. Hematopoietic system The absolute value and percentage of peripheral blood lymphocytes and monocytes increase, but the total number of white blood cells is low. The blood volume is increased and may be accompanied by purpura or anemia and shortened platelet life span. The majority of patients have diffuse, symmetric goiter of varying degrees, which moves up and down with swallowing movements; it is soft, non-pressure, and tougher in chronic patients; the degree of enlargement is not significantly related to the severity of hyperthyroidism. Proptosis usually occurs at the same time as hyperthyroidism, but it can also appear before the appearance of hyperthyroidism symptoms or after the treatment of hyperthyroidism with medication. Treatment of hyperthyroidism includes medication, radioactive iodine therapy and surgery, each with its own advantages and disadvantages. The appropriate treatment plan should be carefully selected according to the patient’s age, gender, severity, duration of illness, thyroid pathology, presence of other complications or co-morbidities, as well as the patient’s wishes, medical conditions and experience of the physician. Anti-thyroid drug therapy is the most widely used, but only 40% to 60% remission rate can be obtained; the remaining two are invasive measures with higher remission rate, but also have some disadvantages. (a) Anti-thyroid drug therapy The advantages are: (i) more certain treatment; (ii) generally does not lead to permanent hypothyroidism; (iii) convenient, economic and safer to use. The disadvantages are: (1) the course of treatment is long, usually 1 to 2 years, sometimes up to several years; (2) the relapse rate is high after stopping the drug, and there is a possibility of secondary failure; (3) in a few cases, serious liver damage or granulocyte deficiency can occur. The commonly used antithyroid drugs are divided into two categories: thiourea and imidazole. (ii) Radioactive 131I therapy takes advantage of the thyroid gland’s high iodine uptake and concentration ability and the destructive effect of beta radiation released from 131I on the thyroid gland to reduce the secretion of thyroid hormones by destroying the follicular epithelium. In addition, it also inhibits the production of antibodies in the lymphocytes of the thyroid gland, which enhances the therapeutic effect. Thus, radioactive iodine therapy is simple, safe and effective. (iii) Surgery The remission rate of subtotal thyroidectomy can be more than 70%, but it can cause many complications, and some cases can still recur or develop hypothyroidism years after surgery. Excessive iodine intake is detrimental to the treatment of hyperthyroidism. Among the foods consumed daily, kelp, seaweed, sea cabbage, sea fish, shrimp, crab and shellfish are rich in iodine. Excessive iodine intake is detrimental to the control of hyperthyroidism. Since iodine is the main raw material for the production of thyroid hormones, excessive iodine intake can aggravate hyperthyroidism and even iodine-derived hyperthyroidism can occur. The remission rate of antithyroid drugs decreases to 20%-35% after excessive iodine intake. Therefore, hyperthyroidism patients should avoid eating foods with high iodine content such as kelp, seaweed and sea fish during treatment, and Chinese medicines containing iodine such as seaweed and kombu should be used with caution. During the treatment period, hyperthyroidism patients are advised to consume non-iodized salt. If the salt is iodized, it is advisable to fry the iodized salt at high temperature for a period of time to allow the iodine to sublimate before consumption. Also. During the treatment period, hyperthyroidism patients should pay attention to the following: avoid spicy food: spicy food, raw onion, raw garlic; kelp, sea shrimp, scallop; strong tea, coffee, tobacco and alcohol. In addition, you should keep your mood calm and prevent overexertion, etc.