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The etiology of hyperthyroidism is complex, and there are many kinds of laboratory tests, mainly including morphological and functional tests. Because each test has its adaptability and limitations, it is impossible for every hyperthyroidism patient to check all the test items. Therefore, it is particularly important to choose the testing items reasonably.

(1) Selection principle: ① Reasonable selection of thyroid morphology and function. Abnormal thyroid morphology and function are two basic characteristics of hyperthyroidism. Most of them have functional and morphological changes at the same time, but some only have abnormal functions. One-sided emphasis on the examination of dysfunction, while ignoring the morphological changes, often omits hyperthyroidism complicated with malignant tumors and nodules. Simply emphasizing morphological changes often misdiagnoses the mass caused by subacute thyroiditis complicated with hyperthyroidism as a thyroid tumor. In a word, the changes of thyroid morphology and function should be considered comprehensively, and the detection items should be selected reasonably to reduce misdiagnosis and missed diagnosis. ② Select effective detection items to improve the accuracy of diagnosis and avoid unnecessary waste. First of all, according to the medical history and clinical manifestations, we should judge whether there is hyperthyroidism or not. Suspected hyperthyroidism patients can choose TT3, TT4, YT3, X 13 1 iodine rate measurement. If there are still doubts about the above tests, you can choose more specific tests, such as FT3, FT4, S-TSH, TRH excitation test and thyroid inhibition test. ③ According to the physiological and pathological characteristics of the patients, select the test items that are harmless to the body and do not affect the judgment of the results. Some examinations of thyroid gland are harmful to the body. Such as coronary heart disease, angina pectoris and atrial fibrillation. Isotope tracer can pass through placenta or milk, resulting in hypothyroidism of fetus or infant, so pregnant and lactating women should not use isotope tracer examination. Oral contraceptives, corticosteroids, salicylic acid and other drugs, as well as physiological and pathological conditions such as pregnancy, liver cirrhosis and nephrotic syndrome, will affect the concentration and binding force of TBG. At this time, TT3 and TT4 should not be selected, but FT3 and FT4 should be selected for determination. Those who have recently taken iodine-containing foods and drugs, or used iodine-containing contrast media, should not take the iodine rate test. In patients with renal insufficiency and heart failure, the binding force of plasma protein to iodine and the excretion function of kidney to iodine change, so TT3, TT4 and iodine tracing examination are not suitable. In a word, when selecting test items, we should avoid waste and damage to patients, and at the same time consider the influencing factors of test results to avoid making it difficult to judge the experimental results.

(2) Laboratory examination steps: ① Judgment of thyroid function: TT4, TT3 and TSH are traditionally used to screen thyroid function. Because TT4 and TT3 are affected by plasma TBG concentration, TSH is insensitive to low values, which makes it difficult to judge the experimental results. With the development of detection technology and the clinical application of S-TSH, FT3 and FT4, it was proposed that S-TSH, FT3 and FT4 should be used to screen thyroid function. S-TSH has a sensitive low value and is of great value in the diagnosis of hyperthyroidism. Moreover, FT3 and FT4 can accurately reflect the thyroid function, and are not affected by TBG and iodine, thus solving many difficult problems. ② Etiological judgment of hyperthyroidism: The most common causes of hyperthyroidism are toxic diffuse goiter, toxic nodular goiter and hyperthyroidism caused by thyroiditis. The diagnosis of hyperthyroidism must be confirmed by laboratory examination results, and the cause of the disease must be found out. The etiology of hyperthyroidism can be diagnosed with iodine uptake rate examination, thyroid radionuclide imaging, B-mode ultrasound, immunological determination and fine needle biopsy of thyroid.