How to relieve itching caused by hyperthyroidism

Hyperthyroidism, abbreviated as "hyperthyroidism", is a disease caused by the thyroid gland synthesizing and releasing too much thyroid hormone, which causes the body's hypermetabolism and sympathetic nerve excitement, leading to palpitations, sweating, increased eating and bowel movements, and weight loss. Most patients also often have symptoms such as exophthalmos, eyelid edema, and decreased vision. There are many causes of hyperthyroidism, and most of us have never heard of these causes. So let’s learn how to relieve the itching caused by hyperthyroidism!

1. Introduction

Hyperthyroidism, also known as hyperthyroidism, is a very common endocrine disease in clinical practice. It refers to a series of hypermetabolic syndromes as well as hyperexcitement symptoms and eye symptoms in multiple systems such as the nervous system, circulatory system, digestive system, cardiovascular system, etc. caused by enhanced thyroid function due to various reasons, excessive secretion of thyroid hormones, or increased levels of thyroid hormones (T3, T4) in the blood. Clinically, the main symptoms of hyperthyroidism patients are: palpitations, tachycardia, heat intolerance, sweating, increased appetite, emaciation, weight loss, fatigue, irritability, irritability, insomnia, lack of concentration, bulging eyes, trembling hands and tongue, goiter or enlargement, menstrual disorders or even amenorrhea in women, and impotence or breast development in men. The thyroid enlargement is symmetrical, while some patients have asymmetrical enlargement. The thyroid enlargement or swelling moves up and down with swallowing, and some patients with hyperthyroidism also have thyroid nodules. There are two types of eye changes caused by hyperthyroidism: benign exophthalmos, in which the patient's eyeballs protrude and the eyes stare or show a look of fear; the other type is malignant exophthalmos, which can be transformed from benign exophthalmos. Patients with malignant exophthalmos often have photophobia, tearing, diplopia, decreased vision, eye swelling and pain, stinging, and foreign body sensation. Because the eyeballs are highly protruding, the eyes cannot close, and the conjunctiva and cornea are exposed, causing congestion, edema, corneal ulcers, and even blindness. Some patients with hyperthyroidism have no eye symptoms or the symptoms are not obvious. The above are typical clinical manifestations of hyperthyroidism, but not every patient with hyperthyroidism has all of these clinical symptoms. Different types of hyperthyroidism have different clinical manifestations.

2. Hyperthyroidism heart disease

The disease can occur in people aged 16 to 73 years, and the incidence rate accounts for 13.4% to 21.8% of hyperthyroidism patients. It often occurs 2 to 3 years after hyperthyroidism. In addition to the typical clinical manifestations of hyperthyroidism, the electrocardiogram often shows sinus tachycardia, atrial fibrillation, atrial flutter, atrioventricular conduction block, premature ventricular contractions, myocardial damage and hypertrophy. Heart enlargement can be of the aortic valve type or of the left and right heart type. Heart disease may improve after hyperthyroidism is cured. This disease should often be differentiated from myocarditis, coronary heart disease, rheumatic heart disease and other heart enlargement diseases.

3. Hyperthyroidism periodic paralysis

This disease mostly occurs in young and middle-aged men and is often confused with hyperthyroid myopathy. Hyperthyroid myopathy has normal blood potassium and abnormal electromyography, while hyperthyroid periodic paralysis has:

① Blood potassium <3.5mmol/L, indicating abnormal potassium metabolism;

② Abnormal potassium distribution: Increased blood sugar can cause potassium to move from outside the cells to inside the cells;

③ The excitability of the central nervous system is enhanced, and the vagus nerve promotes increased insulin release, which can further promote abnormal potassium distribution;

④Immune factors can cause the levels of IATS, LATS-P, T3 and T4 to increase, and thyroid hormones can promote the decrease of potassium levels;

⑤The high adrenergic state of hyperthyroidism can promote a decrease in potassium levels and cause hyperthyroid periodic paralysis. This type should be differentiated from Bartters syndrome, familial periodic paralysis, hypomagnesemia, hyperaldosteronism, myasthenia gravis, and drug-induced hypokalemia.

4. Hyperthyroidism crisis

The incidence accounts for 1% to 2% of hyperthyroidism and is more common in the elderly. It is often related to factors such as infection, mental trauma, surgery, childbirth, overwork, sudden discontinuation of medication, drug reactions and other complications, which aggravate hyperthyroidism and enhance sympathetic nerve activity, leading to crisis. In the early stage of crisis, the fever may reach over 39°C, the pulse rate may reach 120-160 times/min, and there may be restlessness, loss of appetite, nausea, vomiting, diarrhea, mental confusion, profuse sweating, drowsiness, and development to semi-coma and coma. A comatose patient is in critical condition and is in great danger. Increased white blood cell count, abnormal liver function, increased GPT, GOT, bilirubin, etc. may also cause dehydration, hypotension, electrolyte imbalance, acidosis, heart failure and pulmonary edema. Serum T3, T4, FT3, and FT4 may all be elevated, and the mortality rate is high, so timely local rescue is necessary.

5. Hyperthyroidism eye disease

Exophthalmos may occur at the same time as hyperthyroidism, or it may appear before or after the hyperthyroidism improves. The severity of the eye disease is usually not parallel to the hyperthyroidism. In some patients, the hyperthyroidism is not obvious, but the eye disease is very serious. Depending on the severity of the disease, it can be divided into benign exophthalmos and infiltrative exophthalmos. The former is manifested by widening of the palpebral fissure, retraction of the eyelids, staring, reduced blinking and mild exophthalmos; the latter may be manifested by excessive tearing, photophobia, a gray-gray feeling in the eyes, conjunctival edema and congestion, edema of the tissues in the eye sockets, restricted eye movement, double vision, visual field defects, and even loss of vision and blindness. Benign exophthalmos is more common, usually bilateral, and sometimes unilateral exophthalmos can be seen; infiltrative exophthalmos is rare. No specific treatment is needed for benign exophthalmos, only treatment of hyperthyroidism is sufficient. For invasive cases, thyroid tablets can be taken while taking antithyroid drugs. For severe cases, adrenal corticosteroids can be used. A few cases require eye radiotherapy or eye surgery. Regardless of the type of treatment used, it is important to take good care of your eyes during the treatment period (raising the head of the bed when sleeping, wearing sunglasses to avoid light and dust when going out, using eye drops, eye ointment or an eye patch, etc.).

6. Hyperthyroid Myopathy

The more common ones are chronic myopathies with a slow onset. Patients often complain of difficulty squatting, standing up and climbing stairs. Other more special myopathies include periodic paralysis and myasthenia gravis, which are both rare. It is mainly used to treat hyperthyroidism. There is no special treatment except symptomatic treatment.

Nursing

Hyperthyroidism is a chronic disease with no symptoms or atypical symptoms in the early stages. If not treated promptly, the disease may progress to life-threatening conditions such as hyperthyroid crisis and hyperthyroid heart disease. Even with regular treatment, some patients still cannot achieve good results after short-term treatment. Because the disease is difficult to cure, the treatment course is long, the symptoms recur repeatedly, and the mental stress is great, it has a great impact on their life and work. Therefore, it is particularly important to provide good care for patients while actively and regularly receiving treatment. The focus of care is:

1. Alleviate the patient's mental and physical suffering.

2. Prevent the occurrence of complications.

3. Provide daily assistance to patients.

1. General care

1. Get adequate rest and exercise.

When clinical symptoms are significant, bed rest should be the main focus. Activities should be restricted 1 to 2 hours after meals, especially. When clinical symptoms are significantly improved, appropriate activities or physical exercise should be performed while paying attention to rest, but excessive fatigue should be avoided. If there are no clinical symptoms and all laboratory tests are normal, activities can be unrestricted.

2. Emotional care Traditional Chinese medicine believes that a person's mental state is closely related to the body's internal organs, qi and blood, and a person's emotional activities are closely related to the function of the heart to store the spirit. Patients who are energetic and cheerful generally have better therapeutic effects, otherwise it will be worse. Therefore, in nursing, we should care for patients, talk to them more, understand their mental state, and guide them to put aside their doubts.

3. Diet care

The diet should be based on the principles of high calories, high protein, high vitamins, moderate fat and sodium salt intake, and less spicy and irritating condiments. The food should be soft, easy to digest, and rich in nutrition. Do not eat too much high-iodine food, such as kelp, seaweed, jellyfish, seaweed and algae, to prevent poor control of hyperthyroidism. No smoking, no drinking, no strong tea or coffee.

(l) Provide adequate carbohydrates and fats. Carbohydrates and fats have the effect of saving protein. If they are supplied in sufficient quantities, protein can play its unique physiological functions. Provide adequate vitamins and inorganic salts. Vitamins and inorganic salts can regulate physiological functions and improve body metabolism, especially vitamin B and vitamin C. Adequate calcium and iron should be given to prevent deficiency.

(2) Appropriately increase the intake of animal offal, fresh green leafy vegetables, or vitamin supplements.

(3) Appropriately control the intake of foods high in fiber. Hyperthyroidism patients often suffer from diarrhea, and excessive supply of fiber-rich foods will aggravate the diarrhea.

4. Condition care

The main purpose is to observe whether there are symptoms of high metabolic syndrome in the whole body, whether the thyroid gland is enlarged, whether the eyeballs are bulging, whether there are abnormalities in the nervous system, cardiovascular system, digestive system, blood system, reproductive system, and motor system, and whether there are abnormal symptoms such as edema, flushing, dampness, and swollen fingers in the skin and extremities. Pay special attention to changes in body temperature and cardiovascular system to prevent the occurrence of hyperthyroid crisis and hyperthyroid heart disease.