The mental and neurological symptoms of hyperthyroidism can basically be divided into two categories, namely excitatory symptoms and depressive symptoms. Excitatory symptoms are the most common, manifesting as mental hypersensitivity, irritability, increased speech, insomnia and nervousness, inability to concentrate, memory loss, anxiety and suspicion, emotional instability, trembling hands and tongue, often getting angry over trivial matters or feeling depressed, sad and crying , severe cases may manifest as submania or schizophrenia. Depressive symptoms are less common. Clinically, symptoms include apathetic expression, slow reaction, reticence, and reduced movement. At the same time, subtle tremors of eyes, tongue, and hands can also be seen. Physical examination shows hyperreflexia and shortened Achilles tendon reflex time. Symptoms of the cardiovascular system of hyperthyroidism: During hyperthyroidism, due to the excitement and stimulation of the heart by too much thyroid hormone, the oxygen consumption of the myocardium increases and the burden on the heart becomes heavier. A series of cardiovascular symptoms may occur, such as palpitations, chest tightness, shortness of breath, etc. after exercise. Significantly increased. Physical examination: The heart rate is increased, 100 to 120 times per minute, and is still fast during sleep and quiet. The heart beat is enhanced, the first heart sound is hyperactive, and a systolic murmur of grades I to II can be heard in the apex area. Increased cardiac output can lead to an increase in systolic blood pressure, peripheral blood vessel dilation, and a decrease in vascular resistance, which can lead to a decrease in diastolic blood pressure and the appearance of an increase in pulse pressure difference. This is a feature that distinguishes hyperthyroidism and hypertension from hypertension. This disease may still present symptoms of hyperthyroid heart disease such as arrhythmia, cardiac enlargement, and heart failure. Digestive System Symptoms of Hyperthyroidism: Digestive system symptoms of hyperthyroidism: Some patients have an overactive stomach and become hungry easily after eating too much. However, because they consume more than they consume, they often lose weight and become tired and weak. Some elderly patients may experience loss of appetite, anorexia, extreme weight loss, and cachexia. Because thyroid hormone directly acts on the gastrointestinal tract, it causes fast gastrointestinal peristalsis and poor digestion and absorption. Patients often have more frequent stools that are mushy and contain indigestible food, and a few have steatorrhea. When the thyroid gland becomes significantly enlarged and compresses the esophagus, symptoms of swallowing infarction may occur. Some patients may develop abnormal liver function and hyperthyroidism. Hyperthyroid liver disease refers to liver function damage and liver enlargement caused by hyperthyroidism, as well as changes such as elevated transaminases and jaundice. The incidence of abnormal liver function in hyperthyroidism varies widely among reports, accounting for 5% to 91.5% of the total number of hyperthyroidism. The cause is unclear and the mechanism is complex, including direct toxic effects of thyroxine on the liver, liver malnutrition, and hepatic venous stasis. and central lobular necrosis of the liver, infection, shock, aggravation of liver damage and other causes. In addition to evidence of hyperthyroidism, its clinical manifestations also include liver damage, such as elevated transaminases, liver enlargement, tenderness, skin and scleral jaundice, elevated serum bilirubin, and elevated alkaline phosphatase, but generally there is no anorexia. Gastrointestinal symptoms such as nausea and bloating. The hematopoietic system symptoms of hyperthyroidism are divided into three aspects: ① anemia; ② low total number of white blood cells; ③ shortened platelet life span. The cause of leukopenia (mainly granulocytopenia) in patients with hyperthyroidism is unclear. It is currently believed that it may be due to multiple factors. It may be that a large amount of thyroxine inhibits the normal hematopoietic function of the bone marrow, resulting in leukopenia, or it may be that patients with hyperthyroidism produce a protein that targets leukocytes. Antibodies lead to increased destruction of white blood cells, resulting in leukopenia, or a large amount of thyroid hormone leads to abnormal distribution of white blood cells. The degree of leukopenia during hyperthyroidism is relatively mild, mostly between (3-4)×109/L. With the control of hyperthyroidism, the leukocyte count can basically return to normal, so there is no need to take leukocyte-raising drugs. Symptoms of the skeletal system of hyperthyroidism: There are basically two aspects of the skeletal system symptoms of hyperthyroidism: one is osteoporosis, and the other is acromopathy. In hyperthyroidism, thyroid hormone directly acts on the bone marrow, which increases the activity of osteoblasts and osteoclasts, increases the destruction of collagen tissue, increases the conversion rate of bone calcium, causes excessive blood calcium, increases urinary calcium excretion, and eventually leads to bone loss. Porosis. Patients in the early stage have few symptoms. Typical patients often have bone pain, and the ribs, pelvis, and spine are more commonly affected. In severe cases, pathological fractures may occur. X-ray examination shows a decrease in bone density, which can return to normal after hyperthyroidism is cured. Hyperthyroidism acromopathy is less common and is a type of proliferative subperiosteal osteitis. It is characterized by enlarged and thick fingers and toes with a club-like appearance and hypertrophic bone and joint lesions, but blood circulation is not increased. The pathogenesis is unknown. It often coexists with pretibial myxedema and infiltrative exophthalmos. Urinary system symptoms of hyperthyroidism: Symptoms are mainly a significant increase in urine output, due to increased renal blood flow and increased glomerular filtration rate.

Excessive estrogen inhibits the function of testicular interstitial cells and inhibits sperm production, which can lead to a decrease in sperm count, leading to infertility, gynecomastia, and low sexual function. 50% to 60% of female patients may experience reduced menstruation, prolonged cycles or amenorrhea, which not only reduces the chance of pregnancy, but may also lead to miscarriage even if pregnancy occurs. Lactation is seen in both men and women due to increased prolactin (more common in women, less common in men). Most of the above symptoms can return to normal after hyperthyroidism is controlled. Symptoms of the endocrine system of hyperthyroidism: Excessive thyroid hormone not only affects gonadal function, but also often affects pituitary-adrenal function. In the early stage, blood ACTH, cortisol and 24-hour urine 17-hydroxycorticosteroid increase due to stress reaction, and then excessive thyroid hormone Hormone suppression, 17-hydroxycorticosteroids and 17-hydroxyketone steroids both decrease, and the half-life of cortisol is shortened. A large amount of thyroid hormone can promote the absorption of sugar in the intestine, delay the secretion of insulin stimulated by high sugar, and stimulate the secretion of glucagon. Therefore, patients may have impaired glucose tolerance, manifested as postprandial hyperglycemia and positive urine glucose, but fasting Blood sugar does not rise. Clinically, hyperthyroidism can cause diabetes. Diabetes can often be relieved after hyperthyroidism is controlled. Diabetes and hyperthyroidism can also coexist, because both hyperthyroidism and diabetes are related to familial inheritance. Studies have shown that the genetic defects of hyperthyroidism and diabetes are often on the same pair of chromosomes, so they may be linked together and passed on to the next generation.