Cretinism, neonatal respiratory distress syndrome (T3T4 accelerates fetal lung development), myxedema

Sugar: Promote glucose absorption and liver glycogen decomposition Lipids: Accelerate the oxidative decomposition of fats Protein: Large doses promote protein decomposition, small doses promote synthesis Increase oxygen consumption, increase basal metabolic rate, and increase heat production

① Patients with hyperthyroidism should also take T4 when taking antithyroid drugs ②Application of T4 after thyroid cancer surgery ③ Used for differential diagnosis of patients with high iodine uptake rate in T3 suppression test

Inhibits thyroid peroxidase, inhibits iodination and conjugation of tyrosine, and inhibits the synthesis of thyroid hormones

Inhibits the conversion of T4 into T3 in peripheral tissues (propylthiouracil quickly controls T3 levels and is the first choice for the treatment of severe hyperthyroidism and thyroid storm)

Attenuates β-receptor-mediated glucose metabolism

Immunosuppressive effect: Reduces thyroid-stimulating immune globulin, which also has a certain therapeutic effect on the cause of hyperthyroidism.

Methimazole: first choice in general situations Propylthiouracil: Thyroid storm, severe cases, early pregnancy

Medical treatment of hyperthyroidism - suitable for patients with mild symptoms and those who are not suitable for surgery or radioactive iodine therapy

Preparation before thyroid surgery (sulfur first, then iodine) Purpose: Control thyroid function and reduce post-operative complications and thyroid storm Disadvantages: TSH increases after using thioureas, causing gland hyperplasia and congestion. Treatment: Take a large amount of iodine two weeks before surgery

Treatment of thyroid storm: iodine first, then sulfur (large doses of iodine can inhibit the release of thyroid hormone)

gastrointestinal reactions

Anaphylaxis: most common Agranulocytosis: most severe, usually occurs 2-3 months after treatment

Goiter and hypothyroidism

Small dose: Iodine is a raw material for the synthesis of thyroid hormone, preventing simple goiter

High dose: antithyroid effect

The effect is time-limited, and iodide cannot be used alone in the medical treatment of hyperthyroidism: large doses have a rapid and strong effect, taking effect in 1-2 days and reaching the maximum effect in 10-15 days. The concentration of iodine ions in the acinar cells increases to a certain concentration. The ability of cells to take up iodine automatically↓, the intracellular iodide ion concentration↓, and loses the effect of inhibiting hormone synthesis.

Small dose - prevention of simple goiter Large dose: ① Preoperative preparation for hyperthyroidism (sulfur first, then iodine, iodine solution is given 2 weeks before surgery to inhibit TSH's role in promoting gland hyperplasia, shrink and toughen the glands, reduce blood vessels, facilitate surgery and reduce bleeding) ②Treatment of thyroid storm (iodine first, then sulfur)

General reactions: Throat discomfort, metallic taste in the mouth, respiratory tract irritation, sinusitis, conjunctivitis, increased salivation, salivary gland enlargement Allergic reactions: fever, rash, dermatitis, angioedema, laryngeal edema, asphyxia Induce thyroid dysfunction: Long-term overdose induces hyperthyroidism, which can pass through the placenta and breast milk and cause thyroid dysfunction in newborns and infants.

Block beta receptors and improve symptoms of sympathetic-adrenergic system excitement caused by hyperthyroidism

Treatment of hyperthyroidism - suitable for patients with hyperthyroidism who are not suitable for surgery, have relapsed after surgery, are ineffective with thioureas, or are allergic. Determine the iodine uptake function of the thyroid gland - hyperthyroidism (high iodine uptake rate, peak iodine uptake time shifts forward), hypothyroidism (low iodine uptake rate, peak iodine uptake time shifts later)