The thyroid gland is capable of producing and releasing thyroid hormones into the bloodstream. These substances, which are present in small amounts, regulate the normal physiological metabolism of the human body and maintain the normal function of the various systems, organs and tissues of the body, allowing people to live and work normally. For example, if a car engine normally runs at 100 revolutions per minute, hyperthyroidism can make the engine run at 2000 revolutions per minute because the thyroid hormone is very high, and the engine can run normally at 100 revolutions. If the engine reaches 2000 rpm, various symptoms of human discomfort will appear. In recent years, with the increasing pace of social life and the increase in the amount of iodine in the diet, the number of hyperthyroidism has increased significantly, among which toxic diffuse goiter (also known as Graves’ disease) is the most common, and it is believed that this disease is mainly an autoimmune thyroid disease induced by stress factors such as infection and trauma on the basis of genetic susceptibility. Clinical manifestations: 1. Hypothyroidism syndrome (1) Hypermetabolic syndrome: Patients often have fear of heat, excessive sweating, warm and moist skin, hyperphagia but weight loss, and some patients may have abnormally high blood sugar. (2) Neurological and psychiatric symptoms: hypersensitivity, talkative, impatient, easily agitated, often angry over trivial matters, easily insomnia, while some older people are the opposite, showing indifference, weakness and drowsiness. Many patients may have tremors with their hands raised, which is commonly known as “hand tremors”. (3) Cardiovascular system: There may be panic, chest tightness and shortness of breath, and the heart rate may increase significantly at rest and during sleep, more than 100 times per minute. Some patients may experience changes in blood pressure, manifested as an increase in systolic blood pressure and a decrease in diastolic blood pressure, resulting in an increase in pulse pressure difference. Severe patients may have hyperthyroid heart disease, atrial premature beats, atrial fibrillation, or even heart failure. (4) Digestive system: There is often hyperphagia, and the quantity of meals is significantly higher than normal. Some patients describe their intestines as being like rectum after having hyperthyroidism. Patients with severe or persistent hyperthyroidism may have abnormal liver function and jaundice. (5) Blood system: Patients may have reduced granulocytes, relatively increased lymphocytes, anemia and reduced platelets. (6) Genitourinary system: Female patients with hyperthyroidism may have menstrual cycle disorders, thinning hair, amenorrhea, while male patients may have impotence. (7) Muscular and skeletal system: The patient may have muscle weakness or even hyperthyroid myopathy, including acute myopathy, chronic myopathy, periodic paralysis, and myasthenia gravis. Among them, periodic paralysis is mostly seen in male hyperthyroidism patients, manifesting as episodic tetraplegia, which can involve respiratory muscles in severe cases and endanger life. Hyperthyroidism can also cause osteoporosis. 2. Goiter: Most patients with hyperthyroidism may have diffuse symmetrical goiter with significant thickening of the neck, vascular murmur can be detected, and sometimes murmur can be felt. 3. Proptosis: Most patients with Graves’ hyperthyroidism have ocular involvement, with ocular signs appearing in 25-50% of cases. Benign proptosis accounts for 90-95% of the cases, and is characterized by protrusion of one or both eyeballs, contracture of the upper eyelid, widening of the eye fissure, and poor coalescence of the eyes when looking at near objects. In some cases, the protrusion of the eyeball is more pronounced than in benign proptosis, and is accompanied by swelling of the eyelid, conjunctival congestion, edema, impaired eye movement, photophobia, lacrimation, diplopia, inability to close the eyelid, and in severe cases, corneal ulceration, which may lead to blindness if not treated promptly. Routine examination: 1. Serological examination: Patients with initial Graves’ disease have significantly higher serum free T3 and free T4, while TSH is significantly lower and thyrotropin receptor antibody (TRAb) is positive. Imaging: Ultrasound and nuclear scan can determine the location and size of the thyroid gland and the presence of nodules, which is important for the diagnosis and treatment of thyroid disease. In some patients, CT scan is needed to understand the compression of adjacent organs when the enlarged thyroid gland is obvious and the corresponding symptoms of compression of trachea and esophagus appear. 3. Iodine uptake rate of the thyroid gland: Typical patients with Graves’ disease have an increased iodine uptake rate of the thyroid gland, while hyperthyroidism and iodine hyperthyroidism due to thyroiditis often have a reduced iodine uptake rate. The occurrence of hyperthyroidism is closely related to mental tension and heavy mental burden. Foreign data prove that during World War II, due to war factors, many women experienced increased mental stress and the incidence of hyperthyroidism increased significantly compared to that before the war. The modern way of life can easily lead to hyperthyroidism, tension and high work pressure, which are all factors that trigger hyperthyroidism. If we want to prevent hyperthyroidism, we still need to make our lifestyle not too stressful and relax properly. Once the diagnosis of hyperthyroidism is confirmed, we should go to an endocrinology specialist and determine the treatment plan individually according to each patient’s different situation. Since the efficacy of hyperthyroidism medications varies individually for each patient, hyperthyroidism treatment is like walking a tightrope, with a constant balance between medication dose and thyroid function. In addition, it should be pointed out that there is a misconception among some hyperthyroid patients that they need iodine supplementation in particular. While iodine deficiency can cause goiter, the opposite is true for hyperthyroidism, although it can also occur in patients with goiter. Iodine is the raw material for the synthesis of thyroid hormones, and when the thyroid gland, the manufacturing plant, is disturbed, excessive iodine intake will lead to excessive production of thyroid hormones and the corresponding symptoms. Therefore, patients with hyperthyroidism must pay attention to avoid iodine in their diet and avoid seafood, such as kelp, nori, jellyfish, seaweed, sea fish and shrimp, etc. It is better to consume non-iodized salt. Thyroid disorders are complex and include not only hyperthyroidism, but also hypothyroidism, thyroiditis, thyroid nodules, etc. If you think you have a thyroid problem, you should consult a doctor as soon as possible for early diagnosis and treatment so as not to delay your condition.