Seek medical attention
If the patient has unexplained weight loss, hand tremor, palpitation, "thick neck", low fever, diarrhea, muscle weakness, menstrual disorders, amenorrhea, etc., they should go to the endocrinology department in time. After the doctor collects the medical history, he first performs a physical examination, mainly thyroid palpation and heart rate monitoring, and then a thyroid function test, and if necessary, a thyroid imaging test.
Diagnose based on
Patients with the following three items should consider the possibility of hyperthyroidism:
Symptoms and signs of high metabolism (such as: irritability, weight loss, low fever, diarrhea, tachycardia, atrial fibrillation, exophthalmos, etc.);
Enlarged goiter;
Serum thyroid hormone (T3, T4) levels increase, and thyroid-stimulating hormone (TSH) levels decrease.
However, some patients have not obvious symptoms, so special attention should be paid to:
The hypermetabolic symptoms of indifferent hyperthyroidism are not obvious, and may only manifest as weight loss or atrial fibrillation, especially in the elderly;
A small number of patients with hyperthyroidism may not have goiter;
T3 hyperthyroidism only has an increase in serum triiodothyronine (T3);
T4 hyperthyroidism only has an increase in serum thyroxine (T4).
Treatment department
Endocrinology.
Related inspections
Thyroid function test
Including thyroid stimulating hormone (TSH), total thyroxine (TT4), free thyroxine (FT4), total triiodothyronine (TT3), free triiodothyronine (FT3) content detection.
When thyroid function changes, thyroid-stimulating hormone changes more rapidly and significantly than thyroid hormone; FT4 and FT3 levels are not affected by thyroid hormone binding globulin, and can more accurately reflect the functional status of thyroid than TT3 and TT4.
Thyroid autoantibody test
Thyroid-stimulating hormone (TSH) receptor antibody (TRAb) positive may indicate that the cause of hyperthyroidism may be Graves disease. The test also has a certain predictive effect on neonatal hyperthyroidism.
Blood test
Some patients may have a decrease in the total number of white blood cells, an increase in the proportion of lymphocytes, and an increase in mononuclear cells, and occasionally may be accompanied by thrombocytopenic purpura.
Iodine 131 iodine intake rate
At present, it is mainly used to identify the cause of thyrotoxicosis. The uptake rate of 131I (131I) in hyperthyroidism is increased; the uptake rate of 131I in non-hyperthyroidism is reduced.
Thyroid radionuclide scan
This examination is of great significance for the diagnosis of autonomous high-functioning adenomas of the thyroid. There is a large accumulation of radionuclides in the tumor area, and there is no nuclide absorption in the thyroid tissue outside the tumor area and the contralateral thyroid.
Thyroid ultrasound
The test is non-invasive, and the distribution of thyroid blood flow can be seen through ultrasound. Patients with hyperthyroidism may show that the thyroid arterial blood flow speed is increased.
Differential diagnosis
Destructive thyrotoxicosis
Destructive thyrotoxicosis refers to the destruction of thyroid follicular cells caused by inflammatory reactions, chemicals, certain drugs (such as large doses of iodine, interferon, etc.), or mechanical damage, resulting in the release of large amounts of hormones stored in the cells, causing the thyroid gland in the blood Increased hormones, such as subacute thyroiditis, painless thyroiditis, and postpartum thyroiditis.
In these cases, the thyroid's own function of synthesizing hormones is not hyperactive.
Taking exogenous thyroxine
Excessive intake of exogenous thyroid hormones can also cause temporary increases in thyroid hormone levels and thyrotoxicosis. But in this case, the thyroid's own function of synthesizing hormones is not hyperactive.
Simple goiter
Refers to diseases with thyroid enlargement but normal thyroid function and no related clinical symptoms of hyperthyroidism, which can be clearly identified through thyroid function tests.
Hypothyroidism
Referred to as hypothyroidism, symptoms of "thick neck" can also occur. Hypothyroidism is a systemic hypometabolic syndrome caused by reduced thyroid hormone synthesis and secretion due to some reasons. It is distinguished from hyperthyroidism through clinical manifestations and thyroid function tests.
Hyperparathyroidism
Referred to as hyperparathyroidism, it is caused by the synthesis and secretion of excessive parathyroid hormone (PTH) by the parathyroid glands. Patients with hyperparathyroidism have elevated PTH levels and normal thyroid hormone levels, which can be differentiated from hyperthyroidism.
Account not verified