Overview of Hyperthyroidism
Hyperthyroidism is a disorder of physical symptoms and neuropsychiatric disorders caused by overproduction of thyroxine. Almost all patients with this disease suffer from varying degrees of psychiatric symptoms, and psychiatric disorders are an integral part of all clinical manifestations of the disease.
Causes
1. Endocrine disorders, mental disorders are related to hyperreceptivity of β-adrenoceptors.
2. Metabolic disorders and toxic substances.
3. Increased permeability of brain cell membranes.
4. psychological factors.
5. personality traits.
Symptoms
1. Mood changes mainly, manifested as nervousness and impulsiveness, allergy and suspicion, fear and anxiety, or depression and anxiety, or joy and pleasure, busyness in action, losing sight of one thing and another, accompanied by decreased libido, abnormal appetite, sleep disorders, menstrual disorders and so on.
2. Depression or mixed state of mania and depression may occur.
3. Delusions and delirium may occur.
Examination
1. Serum TSH, T3, T4 examination.
2. Electroencephalography.
3. Basal metabolic rate measurement.
4. Thyroid iodine uptake test.
Diagnosis
Diagnosis can be made on the basis of history, clinical symptoms and laboratory data. Other organic mental disorders, affective disorders, schizophrenia and neurosis are excluded.
Differential diagnosis
Rule out other organic mental disorders, affective disorders, schizophrenia and neurosis.
Treatment
1. Antithyroid drugs
Should be the first choice of treatment for hyperthyroidism. The first choice of imidazole class of dibazole and hyperthyroidism, such as intolerance, can be used for the thiourea class of methyl thiouracil and propyl thiouracil; thiourea and imidazole class of antithyroid drugs pharmacological effect is to inhibit the peroxidase system in the thyroid, inhibit iodine ions converted to the new ecological iodine or reactive iodine, so as to hinder the iodine and kojic acid binding, blocking the synthesis of thyroxine. Propylthiouracil can also inhibit the conversion of T4 to T3 in peripheral tissues.
2. Radioactive 131 iodine therapy
The thyroid gland has the ability to highly concentrate 131 iodine. When 131 iodine decays, it emits β and γ rays (99% of which are β rays), and the range of β rays in the tissues is only 2mm, so the ionizing effect is only limited to the local area of the thyroid gland without affecting the neighboring tissues.
3.Surgery
Subtotal thyroidectomy is one of the effective treatments for hyperthyroidism, which can be cured in most of the patients, and can weaken the autoimmune reaction, with a low recurrence rate.
4.Treatment of comorbidities
Infiltrative proptosis, localized mucous edema, thyroid crisis, etc.
5. Treatment of mental retardation