What clinical symptoms can help us diagnose thyroid dysfunction?

In clinical practice, in addition to a thicker neck, which can provide clues to thyroid enlargement, there are many other clinical symptoms that can help us determine whether the thyroid function is abnormal. We can also use these clinical manifestations to determine whether the thyroid function of adults is abnormal.

(1) Afraid of heat or cold: In hyperthyroidism, the thermogenic response is enhanced, and the patient's heat production and heat dissipation increase. In hypothyroidism, thyroid hormone is insufficient, the thermogenic response is weakened, and the body's heat production and heat dissipation decrease. The patient is afraid of cold and has a low body temperature.

(2) Skin symptoms, hyperhidrosis or hypohidrosis: Thyroid hormone can stimulate the excitability of the sympathetic nerves and also promote the metabolism of proteins, electrolytes and water. The activity of sweat glands is controlled by the sympathetic nerves.

(3) Weight gain or loss: In hyperthyroidism, the basal metabolic rate increases, the decomposition metabolism is greater than the anabolic metabolism, the weight decreases, and in the short term, there may be obvious weight loss and decreased cholesterol. In hypothyroidism, both the anabolic and decomposition metabolisms slow down, the metabolic disorder is obvious, the retention of water and metabolic products is serious, and there may be weight gain and increased cholesterol.

(4) Changes in heart rate. Is the heart rate accelerating or slowing down? In hyperthyroidism, the heart contracts more strongly, oxygen consumption increases, and the heart rate accelerates to more than 90 beats per minute. Atrial fibrillation may also occur, and the patient may feel palpitations, chest tightness, shortness of breath, and even angina. In hypothyroidism, the heart contracts less strongly, and the heart rate may drop below 60 beats per minute. The heart may swell and pericardial effusion may occur. The patient may also feel palpitations, shortness of breath, chest tightness, and other symptoms of heart disease.

(5) Is the reaction sensitive or dull? In hyperthyroidism, nerve excitement increases, and muscle tremors, muscle spasms, and enhanced muscle reflexes may occur. In hypothyroidism, nerve conduction and reflexes are weakened, and the patient's movements are slow, muscles spasm, and muscle reflexes are weakened.

(6) Mental excitement, emotional irritability, abnormal enthusiasm and hyperactivity; or apathy, sluggish reaction, slow movements, drowsiness and lethargy: Thyroid hormone is also an important hormone that supports the functional tension of the central nervous system. In hyperthyroidism, the excitability of the central nervous system increases, and the patient will become excited, irritable, easily emotional, or have personality changes, becoming abnormally enthusiastic, talkative and hyperactive, and even mental disorders, schizophrenia, etc. In hypothyroidism, the excitability of the central nervous system decreases, and the patient will have apathy, slow movements, sluggish reaction, drowsiness and lethargy, and is prone to depression.