No nuclear medicine doctor wants to treat hyperthyroidism into hypothyroidism, and curing the patient is the goal to which we aspire. But with the current level of care, it is inevitable that any doctor will treat a patient for hypothyroidism, including physicians and surgeons, and including American doctors. Even with the most precise doses of medication, this inevitably happens, and it is a medical challenge. Once hypothyroidism is diagnosed, its treatment is simple. By using levothyroxine replacement therapy, the patient can live like a normal person with the right amount of thyroid hormone supplementation, which will not cause side effects such as damage to the patient’s liver and kidney function and hematopoietic system. Rapid treatment of hyperthyroidism is conducive to improving the quality of life, and the quality of life of hypothyroid patients is much higher than that of hyperthyroid patients, which is a positive regression after treatment of hyperthyroidism. Refractory hyperthyroidism patients are either in a state of delayed hyperthyroidism or in a state of replacement therapy for hypothyroidism, with less likelihood of healing. If the patient is not comfortable with hypothyroidism after 131 iodine therapy, then do not choose 131 iodine therapy!