Hyperthyroidism, referred to as hyperthyroidism, is due tothyroidExcessive activity leads to excessthyroid hormoneA disease caused by the production and secretion of.There are many reasons for hyperthyroidism, the most common one is caused by excessive thyroid stimulating hormone receptor antibody (TRAb)Graves disease。The causes of hyperthyroidism also include multinodular toxic goiter, thyroid high function adenomaGene mutationCaused byThyroid noduleoradenoma、Iodine hyperthyroidismEtc.The incidence of hyperthyroidism in women is higher than that in men. Young women are prone to Graves disease, while the elderly are more prone to Graves diseaseNodular toxic goiter。
The common symptoms of hyperthyroidism include irritability, irritability, tachycardia, fatigue, fear of heat, sweating, weight loss, hyperappetite, etc. Hyperthyroidism is not infectious.In addition, some patients will have exophthalmos, periodic paralysis or muscle weakness, and some women have hyperemesis gravidarum.
The treatment of hyperthyroidism mainly includes medication, treatment and surgery.Medication is usually usedAntithyroid drugs(ATD), mainly by inhibiting the synthesis of thyroid hormones;Iodine 131 treatment can destroy thyroid cells and reduce thyroid hormone levels;Surgical treatment is to remove the thyroid gland surgically, thereby reducing thyroid hormone levels.The treatment choice of patients varies due to their different conditions, complications, age, gender, pregnancy status, personal choice and other factors.
About the gain information of hyperthyroidism, there may be family or genetic factors in hyperthyroidism patients whose close relatives have suffered from the disease. In additionestrogen, autoimmune diseases, severe mental stimulation and other factors may also induce hyperthyroidism.
Irritability, irritability, tachycardia, fatigue, fear of heat, sweating, weight loss, hyperappetite, increased stool frequency or diarrhea, lack of menstruation
The overall prevalence of hyperthyroidism in the general population is about 1.3%, of which about 0.5% has obvious symptoms.Generally speaking, the incidence of hyperthyroidism in women and smokers is high;Young women are more likely to have diffuse goiter with hyperthyroidism (Graves disease), while older people are more likely to have multinodular toxic goiter.
infectivity
The disease is not infectious and is not infectious.
pathogeny
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Hyperthyroidism is caused by over active thyroid function and increased self synthesis and secretion of thyroid hormones.There are many causes of hyperthyroidism and different mechanisms,Graves disease、Thyroid nodule、Thyroid tumorAnd other disease factors, as well as high intakeiodineOf food or drugs, may cause hyperthyroidism.
Pathogenesis
Generally, the human body itselfthyroidProducing and secretingthyroid hormoneIt can meet the needs of the body. Hyperthyroidism occurs when the thyroid itself produces too much thyroid hormone.There are many causes of hyperthyroidism, the most common of which is Graves' disease, and others include multinodular toxic goiter, thyroid autonomous high function adenoma, sporadic or familial non autoimmune hyperthyroidismIodine hyperthyroidism, human chorionic gonadotropin (hCG) related hyperthyroidism, pituitary thyroid stimulating hormone (TSH) tumor hyperthyroidism andneonatal hyperthyroidism Etc.
Diffuse toxic goiter
Also known as Graves' disease (GD), the specific antibody produced in this kind of patients - thyroid stimulating hormone receptor antibody (TRAb), causes hyperplasia of thyroid cells, produces excessive thyroid hormone and leads to hyperthyroidism.This is the most common cause of hyperthyroidism, accounting for about 80% of all hyperthyroidism.
Toxic Multinodular Goiter
It is also known as toxic multinodular goiter. This kind of situation is due to "out of control" in the production of thyroid hormone and excessive secretion of thyroid hormone, which causes hyperthyroidism. It mostly occurs in the elderly in iodine deficient areas, with more women than men.
Autonomous high function thyroid nodule/adenoma
About 5% of hyperthyroidism is caused by the disease, most of which are caused by the formation of nodules or adenomas due to gene mutations in thyroid cells, and can spontaneously synthesize thyroid hormones.When this "autonomous" synthesis of thyroid hormone is excessive, it will cause hyperthyroidism.It is generally seen in people aged 30-40 years.
Iodine hyperthyroidism
This is hyperthyroidism associated with increased iodine intake.Hyperthyroidism induced by excessive iodine intake in the short term (such as taking iodine supplements or iodine containing drugs) and iodine supplementation of people exposed to iodine deficiency environment for a long time, mostly occurs in patients with nodular goiter.
Sporadic or familial non autoimmune hyperthyroidism
It is a rare cause.It is mainly because of the embryogenic mutation of thyroid stimulating hormone receptor (TSHR), which increases the activity of thyroid stimulating hormone receptor (TSHR) after mutation, and promotes thyroid cell proliferation and thyroid hormone synthesis, thus causing hyperthyroidism.
Hyperthyroidism associated with human chorionic gonadotropin (hCG)
HCG and TSH have the sameαSubunit, similarβThe subunits and receptors, hCG, have mild stimulatory effects on TSH receptors of thyroid cells.After some women become pregnant, the placenta produces a large amount of hCG, which can promote the thyroid gland to overproduce thyroid hormone.
In addition, trophoblastic diseases such as testicular cancer and hydatidiform mole can also produce large amounts of hCG, leading to increased thyroid hormone synthesis.
TSH adenoma of pituitary
Pituitary TSH adenoma refers to some benign pituitary tumors that can secrete a large amount of TSH, resulting inGoiterAnd thyroid hormone excess, which causes hyperthyroidism.
Fetal/Neonatal Hyperthyroidism
The disease is mainly due to Graves' disease of the mother during pregnancy. The mother's thyroid stimulating hormone receptor antibody (TRAb) enters the fetus through the placenta, resulting in hyperthyroidism of the fetus/newborn.
Predisposing factors
Family or genetic factors
It has been reported that 1/4~1/5 of hyperthyroidism patients' close relatives have also suffered from the disease, perhaps the same living environment and genetic background are related to their familial characteristics.
female sex
FemaleestrogenIt can up regulate the thyrotropin releasing hormone (TRH) receptor of pituitary cells, promote the secretion of TSH, and thus induce hyperthyroidism.
History of autoimmune diseases
Autoimmune diseases can induce hyperthyroidism.
Severe mental stimulation
Some patients have obvious history of mental stimulation or trauma, such as anxiety, sadness and panic, before clinical symptoms appear.Severe mental stimulation can cause thyroid dysfunction, and reduced adrenal cortical hormone can not effectively inhibit thyroid secretion, thus leading to hyperthyroidism.
symptom
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Hyperthyroidism often has symptoms such as irritability, irritability, tachycardia, fatigue, fear of heat, excessive sweating, weight loss, hyperappetite, increased stool frequency or diarrhea, and lack of menstruation. Because it is similar to many other diseases, it is often confused.
early symptom
There are no specific early symptoms of hyperthyroidism. The early symptoms depend on the severity of hyperthyroidism, affected organs and individual differences of patients. Each typical symptom may become an early symptom.
Typical symptoms
Weight loss and emaciation, even if the amount of food has not decreased or even increased;
Hyperappetite, fast intestinal peristalsis, increased stool frequency, or diarrhea;
Persistent tachycardia, usually more than 100 beats/minute, can cause palpitations;
Some patients may have atrial premature contraction, atrial fibrillation and other arrhythmias, and patients may feel flustered and uncomfortable;
Patients may suffer from nervousness, anxiety, insomnia, irritability and inattention;
Hands tremble, which will affect normal work and life in serious cases;
Sweating and heat resistance;
Female patients may have menstrual cycle changes, which are generally manifested as prolonged menstrual cycle, scarce menstruation, or even amenorrhea;
Most patients may have varying degrees of goiter, and "thick neck" can be seen in severe cases;
Common skin thinning, smooth, delicate, warm and moist;
Some hair may fall off, and the hair becomes thin and easy to break.
Accompanying symptoms
Exophthalmos
Most patients with hyperthyroidism have different degrees of eye symptoms, which can be divided into two categories: one is simple exophthalmos, which is characterized by mild exophthalmos, widened eyelid fissure, and reduced blinking times.The other is invasive exophthalmos (Graves' ophthalmopathy), with more prominent exophthalmos, accompanied by intraocular foreign body sensation, photophobia, pain, tears, diplopia, and decreased vision.
Periodic paralysis or muscle weakness
It may be accompanied by periodic paralysis (mostly Asian or young men), or progressive muscle weakness and atrophy. The latter is called hyperthyroid myopathy, which mainly occurs around the shoulder and pelvis.
Hyperemesis gravidarum
High concentrations during pregnancyHuman chorionic gonadotropin(hCG) stimulates thyroid hormone secretion, causing hyperemesis gravidarum.
Dizziness and headache
Hyperthyroidism patients may be accompanied by increased systolic blood pressure, decreased diastolic blood pressure and increased pulse pressure, resulting in dizziness, headache and other discomfort.
Medical treatment
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If the patient has unexplained weight loss, shaking hands, panic, "thick neck", low fever, diarrhea, muscle weakness, menstrual disorder, amenorrhea and other symptoms, he should go to the endocrine department in time.After the doctor collects the medical history, he will first perform physical examination, mainly thyroid palpation and heart rate monitoring, and then perform thyroid function test, and thyroid imaging examination if necessary.
Diagnostic basis
The patient has the following three possibilities:
Hypermetabolic symptoms and signs (such as irritability, weight loss, low fever, diarrhea, tachycardia, atrial fibrillation, exophthalmos, etc.);
However, some patients' symptoms are not obvious, and special attention should be paid to:
Hypermetabolic symptoms of indifferent hyperthyroidism are not obvious, and may only be manifested as emaciation or atrial fibrillation, especially in the elderly;
A few patients with hyperthyroidism may not have goiter;
Only serum triiodothyronine (T3) increased in type T3 hyperthyroidism;
Only serum thyroxine (T4) increased in type T4 hyperthyroidism.
When thyroid function changes, TSH changes more rapidly and significantly than thyroid hormone;The levels of FT4 and FT3 are not affected by thyroid hormone binding globulin, and can more accurately reflect the functional state of thyroid than TT3 and TT4.
Determination of thyroid autoantibody
Positive thyroid stimulating hormone (TSH) receptor antibody (TRAb) may indicate that the cause of hyperthyroidism may be Graves disease.This examination also has a certain predictive effect on neonatal hyperthyroidism.
At present, it is mainly used to identify the cause of thyrotoxicosis, hyperthyroidism type thyrotoxicosis iodine 131（one hundred and thirty-one1) The uptake rate increased;Thyrotoxicosis of non hyperthyroidism typeone hundred and thirty-oneI Decreased uptake.
Thyroid radionuclide scanning
This examination is of great significance for the diagnosis of thyroid autonomous high function adenoma. There is a large amount of radionuclide accumulation in the tumor area, and there is no radionuclide absorption in the thyroid tissue outside the tumor area and the opposite thyroid.
Thyroid ultrasound
The examination is non-invasive. The thyroid blood flow distribution can be seen through ultrasound examination. Hyperthyroidism patients can show increased blood flow velocity of thyroid artery.
differential diagnosis
Destructive thyrotoxicosis
Destructive thyrotoxicosis refers to the destruction of thyroid follicular cells caused by inflammatory reaction, chemistry, certain drugs (such as high-dose iodine, interferon, etc.) or mechanical damage, which causes a large amount of hormone stored in the cells to release, causing the increase of thyroid hormone in the blood, such as subacute thyroiditis, painless thyroiditis, and postpartum thyroiditis.
In these cases, the thyroid itself is not overactive in the synthesis of hormones.
Taking exogenous thyroxine
Excessive intake of exogenous thyroid hormone can also cause temporary elevation of thyroid hormone level, resulting in thyrotoxicosis.However, in this case, the thyroid itself is not overactive in hormone synthesis.
Although the nail gland is swollen, the disease with normal thyroid function has no clinical symptoms related to hyperthyroidism, which can be clearly identified through thyroid function examination.
Abbreviated as hypothyroidism, the symptoms of "thick neck" will also appear.Hypothyroidism is a systemic hypometabolic syndrome caused by the reduction of thyroid hormone synthesis and secretion for some reasons. It is distinguished from hyperthyroidism by clinical manifestations and thyroid function tests.
It is called hyperparathyroidism for short, which is caused by excessive parathyroid hormone (PTH) synthesis and secretion by the parathyroid gland.Patients with hyperparathyroidism have elevated PTH levels and normal thyroid hormone levels, which can be differentiated from hyperthyroidism.
treatment
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At present, the treatment of hyperthyroidism is drug therapy, iodine 131 therapy and surgery. Their main purpose is to reduce the elevated thyroid hormone level. The three treatments are effective, but each has advantages and disadvantages.
Acute treatment
There is no "acute phase" in the development of hyperthyroidism.Generally, thyroid crisis is regarded as an acute and severe case of hyperthyroidism in clinic, which needs emergency treatment and timely rescue, and can be understood as acute treatment.
Thyroid crisis is often seen in untreated or insufficiently treated patients with hyperthyroidism. Once it occurs, it needs to be rescued in time.First, quickly correct the imbalance of water, electrolyte and acid-base balance, and keep the vital signs light.Simultaneously through drugs（PropylthiouracilIodine agentPropranolol、GlucocorticoidIt can inhibit the synthesis and release of thyroid hormone and fight against stress state, and reduce the level of thyroid hormone in blood through dialysis when necessary.
Patients with existing complications and complications should be given symptomatic treatment, including oxygen supply, prevention and treatment of infection, etc.Physical cooling should be given to those with high fever, and acetylsalicylic acid drugs (such asaspirin）Because acetylsalicylic acid drugs can increase the level of free thyroid hormone in blood.
General treatment
The general treatment of hyperthyroidism includes paying attention to rest, regular exercise, quitting smoking and limiting alcohol, supplementing enough calories and nutrition, and controlling the iodine content in diet.
At the same time, attention should be paid to avoiding the use of iodine containing drugs (such asamiodarone ）And iodized contrast agent to reduce the intake of iodine rich foods such as kelp.
ATD mainly treats hyperthyroidism by inhibiting the synthesis of thyroid hormones.The cure rate of simple antithyroid drug treatment is only 40%, and the recurrence rate is as high as 50%~60%.At present, the commonly used drugs are formamide imidazole (MMI) and propylthiophene (PTU).
ATD is applicable to patients with mild illness, mild to moderate goiter, or those who cannot tolerate surgery due to pregnancy, aging and infirmity, and other diseases.In addition, it can also be used in the preparation stage before surgery and radioiodine treatment, patients who relapse after surgery but are not suitable for radioiodine treatment, or patients with moderate to severe active Graves' ophthalmopathy.
Before the treatment of antithyroid drugs, it is recommended to test the blood routine and liver function, and the test results should be basically normal before use.Attention should be paid to anaphylactic and toxic reactions when using such drugs, such asNeutropenia、rash、Toxic hepatopathyandVasculitisEtc.
It can be used as an auxiliary treatment during the initial treatment of antithyroid drugs, can quickly control the clinical symptoms of hyperthyroidism, and has little impact on thyroid hormone levels. Propranolol is the commonly used drug.Patients with asthma, chronic obstructive pulmonary disease and congestive heart failure should not use it. Pregnant patients with hyperthyroidism should use it with caution.
Iodine agent
It is used for preoperative preparation, thyroid crisis and serious thyrotoxic heart disease, which can reduce thyroid congestion and inhibit the synthesis and release of thyroid hormones. It is usually given together with antithyroid drugs, which is temporary.
surgical treatment
The advantages of surgical treatment of hyperthyroidism are high surgical cure rate, low mortality and low recurrence rate, while the disadvantages are the risk of postoperative complications.
Indications and contraindications
Surgical treatment is mainly applicable to the following situations:
Patients with moderate or severe hyperthyroidism, who are ineffective after taking medicine for a long time, relapse after stopping taking medicine, or are unwilling to take medicine for a long time;
The thyroid gland is huge or accompanied by nodules, with compression symptoms;
Substernal goiter with hyperthyroidism;
Nodular goiter with hyperthyroidism;
Hyperthyroidism patients suspected of malignant change.
At the same time, attention should be paid to the contraindications of hyperthyroidism surgery:
Persons with other serious systemic diseases;
Poor general condition, unable to tolerate surgery;
Patients with early and late pregnancy.
Postoperative care
After thyroidectomy, the patient should take medicine according to the doctor's advice.In addition, the patient should be in a semi recumbent position (the upper body should be raised about 30 degrees) to facilitate breathing and congestion drainage of the surgical incision.In addition, family members should help and encourage patients to expectorate actively to keep the respiratory tract unobstructed.
Surgical complications
After surgical treatment, patients may suffer from wound bleeding, respiratory tract infection, injury of recurrent or superior laryngeal nerve, hypocalcemia caused by hypoparathyroidism, and complications caused by general anesthesia.
Because part or all of the thyroid gland is removed, patients may need to take levothyroxine to maintain normal thyroid hormone levels after surgery, and regularly review thyroid function according to the doctor's instructions.
TCM treatment
Traditional Chinese medicine believes that the initial stage of hyperthyroidism is stagnation of liver qi and transformation of liver qi into fire, and the treatment is mainly to clear the liver and expel the liver.In the middle and late stages, the liver fire is fiery, the phlegm is coagulated, and even the qi and yin are deficient. The treatment mainly focuses on purging fire, supplementing qi, and nourishing yin, and at the same time, attention should be paid to resolving phlegm and promoting blood circulation.
Other treatments
Radioiodine therapy
The patients take radioactive iodine orally and use its radiation to destroy thyroid tissue, reducing the release of thyroid hormone.The cure rate of this treatment is high and the recurrence rate is relatively low.
Indications and contraindications
Radioiodine therapy is mainly applicable to the following situations:
Thyroid enlargement above moderate level;
Antithyroid drug allergy;
Recurrence after antithyroid drugs or surgical treatment;
Hyperthyroidism combined with functional damage of heart, liver, kidney and other organs;
Patients who refuse surgical treatment or have surgical contraindications.
Radioiodine treatment should be avoided as far as possible for moderate and severe active exophthalmos. Radioiodine treatment is prohibited during pregnancy and lactation.
matters needing attention
This treatment can lead to hypothyroidism, which is considered as one of the signs of hyperthyroidism cure.After radioactive iodine treatment, thyroid function should be monitored regularly, hypothyroidism should be found as soon as possible, and hormone replacement therapy should be given.After treatment, some patients may suffer from radiation thyroiditis, thyroid crisis or hyperthyroidism, which may worsen in a short period of time. They need to follow the doctor's advice for observation, follow-up and treatment.
Patients should eat low iodine diet 1~2 weeks before receiving radioactive iodine treatment, and avoid using iodized contrast agents and drugs.
Treatment of Graves ophthalmopathy
In general, when sleeping, the pillow should be high, and quitting smoking and limiting sodium salt can alleviate the disease.Wear colored glasses to protect eyes during the day, use artificial tears, and use 1% methyl cellulose eye drops at night.Those whose eyelids cannot be closed during sleep can use saline gauze to apply eyes or wear eye mask to protect the cornea.
Patients with moderate to severe active Graves ophthalmopathy should receive glucocorticoid treatment.If the patient cannot tolerate glucocorticoid or the glucocorticoid treatment is ineffective, or the patient has corneal infection or ulcer, retinal or optic neuropathy caused by compression that may lead to blindness, orbital decompression surgery is required.
Treatment of hyperthyroidism during pregnancy
Timing of pregnancy
Generally speaking, pregnancy is not recommended for patients with uncontrolled hyperthyroidism.After the thyroid function of the patient who is receiving antithyroid drug treatment returns to normal, ask the doctor whether she can be pregnant.
Drug treatment during pregnancy
Since antithyroid drugs can cause fetal malformation and inhibit fetal thyroid function, if possible, during pregnancy, especially in the first 12 weeks of pregnancy, it is best not to take antithyroid drugs. If it is really necessary to take antithyroid drugs, the drug dose should be adjusted according to the maternal serum free thyroxine (FT4) content. Propylthiouracil is preferred for treatment in the first 12 weeks of pregnancy.
Drug treatment during lactation
If lactating women need antithyroid drugs, they should balance the advantages and disadvantages of the drugs and try to use smaller doses of antithyroid drugs.
Mothers should take medicine after breastfeeding.
prognosis
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The prognosis is generally good after standard treatment.
However, it should be noted that patients with hyperthyroidism who have not been found and actively treated may suffer from multiple organ involvement due to disease progression, especially the heart, and even death due to thyroid crisis.
Curative
The cure rate of oral medicine is generally about 50%;The cure rate of operation and iodine-131 treatment is high, and the recurrence rate is low, but there is a possibility of hypothyroidism.
self-healing
Hyperthyroidism is not a self limited disease and will not heal without treatment.
harmfulness
The symptoms caused by hyperthyroidism, such as irritability, irritability, insomnia, palpitations, fatigue, hyperhidrosis, and periodic paralysis, seriously affect the work and life of patients;
Graves ophthalmopathy caused by hyperthyroidism can cause discomfort such as eye swelling, pain and dim light, and reduce vision;
The pretibial mucoedema caused by hyperthyroidism can thicken and thicken the skin of the lower leg, such as orange peel and bark, affecting the appearance. The pretibial mucus can occasionally occur in the upper limbs, surgical scars and even the face;
Thyroid crisis caused by acute exacerbation of hyperthyroidism has a mortality rate of more than 20%;
Hyperthyroidism can also affect the heart, leading to atrial fibrillation, heart failure and other heart diseases;
After surgery or 131I treatment, hyperthyroidism may also cause hypothyroidism due to excessive destruction of thyroid tissue, requiring lifelong thyroxine administration.
seriousness
Thyroid crisis and heart damage may directly or indirectly lead to death of patients.
complication
Hyperthyroid ophthalmopathy
Hyperthyroidism ophthalmopathy is mainly characterized by exophthalmos and bulging eyes. In severe cases, the eyes on both sides will be asymmetrically protruding, and photophobia, tears, and vision loss will also occur.Hyperthyroidism ophthalmopathy has two main manifestations: one is simple exophthalmos, which is mainly related to the sympathetic nerve excitation caused by excessive thyroid hormone;The other is invasive exophthalmos, namely Graves' ophthalmopathy, which is related to the autoimmune inflammatory reaction in the surrounding tissues of the orbit.
This is one of the more serious complications of hyperthyroidism, which often causes malignant arrhythmia, and even death in serious cases.The patients mostly showed tachycardia, increased cardiac output, atrial fibrillation and heart failure.
Excess thyroid hormone in hyperthyroidism patients will affect the speed of bone formation and absorption, which may lead to faster bone absorption than bone formation, lower bone mass, and then lead to osteoporosis.
This is the specific skin damage of Graves' disease, which is mostly seen at the front 1/3 of the shank, and the skin damage is mostly symmetrical.At the beginning, it presents dark purplish red skin lesions, followed by thick skin, stacked in flakes or nodules, and finally presents bark, covered with gray or black warts. The lower limbs are thick like elephant skin legs.
Patients may show muscle weakness, muscle atrophy, and hypokalemic periodic paralysis. In severe cases, respiratory muscle paralysis may occur, or it may coexist with myasthenia gravis.
daily
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Patients with hyperthyroidism should first receive standardized treatment and return regularly.At the same time, patients should adjust their lifestyle, work and rest regularly, eat reasonably, quit smoking and drinking, and eliminate adverse mental stimulation.
Daily life management
diet
Hyperthyroidism patients have increased basic metabolism and usually consume a lot of energy, so heat supply should be guaranteed.It is advisable to give a diet rich in calories, vitamins, protein and minerals.
Diet recommendation
The staple food should be sufficient, which can increase high-quality protein such as milk, eggs and lean meat;
Take more fresh vegetables and fruits to supplement vitamins;
Patients are encouraged to drink more water, 2000ml~3000ml daily to supplement the water lost due to sweating, diarrhea, rapid breathing, etc. However, patients with heart disease should avoid drinking a lot of water to prevent edema and heart failure due to increased blood volume.
Food taboos
It is forbidden to take stimulating food and drinks, such as strong tea, coffee, etc., to avoid causing mental excitement of patients;
Reduce the intake of medium crude fiber to reduce the frequency of defecation;
Avoid food rich in iodine, eat iodized salt, and avoid kelp, sea fish and laver;
Eat cautiouslyCabbage、CabbageAnd other foods that are easy to cause goiter.
motion
Patients with hyperthyroidism should exercise regularly, because it can help improve their quality of life, maintain good muscle tension, protect the cardiovascular system, and reduce their appetite.In addition, weight bearing exercise can also effectively maintain the bone density of patients with Graves disease.
life style
Patients with hyperthyroidism should work and rest regularly, quit smoking and drinking, not stay up late, use less eyes, watch less mobile phones, TV, etc., wear colored glasses to protect their eyes from the sun and wind, and use eye drops to reduce dry eyes and itching eyes.
Patients with hyperthyroidism should control their emotions and should not quarrel, get angry or get excited. Family members and friends should understand the patients and avoid mental stimulation.
Daily condition monitoring
During the treatment period, patients should see doctors on time, regularly monitor thyroid function, and timely adjust the treatment plan according to thyroid function.
Special precautions
Occurrence of hyperthyroidism in pregnant womenabortion、premature delivery、Pre eclampsia、Placental abruptionThe probability of fetal intrauterine growth retardation, fetal or neonatal hyperthyroidism and other phenomena will increase.Therefore, pregnancy is not recommended for those with uncontrolled hyperthyroidism.
If the patient's hyperthyroidism has been effectively controlled, she can get pregnant after consulting a professional doctor. During pregnancy, the thyroid function of the pregnant woman and the fetal development should be monitored regularly.
prevention
Reasonable diet
Long term iodine deficiency or iodine excess can lead to hyperthyroidism. Therefore, appropriate iodine intake should be maintained in daily diet.
Avoid mental inducements
Some patients with Graves' disease have had a history of obvious mental stimulation or trauma before onset. Therefore, we should pay attention to the combination of work and rest, timely dispel bad emotions, and seek the help of professional psychologists when necessary.
