Will hyperthyroidism cause a sore throat?

Hyperthyroidism is a disease caused by the abnormality or hyperfunction of the thyroid tissue in the human body. Because the thyroid tissue plays an endocrine role in the human body, it can secrete some thyroid fluid to promote the endocrine function of the human body. Suffering from hyperthyroidism will affect a person's overall endocrine condition. But when a person suffers from hyperthyroidism, will he experience sore throat?

Early symptoms of hyperthyroidism

Most children develop the disease during adolescence, and it is rare for those < 5 years old. The clinical course of hyperthyroidism in children varies greatly from person to person. Generally, symptoms gradually worsen, and the time from the onset of symptoms to diagnosis is usually 6-12 months. The symptoms of this disease are not very obvious and progress slowly at the beginning. They often first present as mild behavioral changes such as emotional instability, inattention in class, irritability, hyperactivity and inattention. Other symptoms may include increased appetite, weight loss, fear of heat, excessive sweating, palpitations, and agitation. As long as parents feel that their children have some abnormal behavior, they should take their children to see a doctor as soon as possible for early diagnosis and early treatment.

Typical symptoms and signs include:

1. Increased sympathetic nerve excitability

An increase in basal metabolic rate is accompanied by symptoms such as weight loss, sweating, heat intolerance, low fever, increased appetite, increased frequency of bowel movements, sleep disorders and fatigue. Due to the overexcitement of the sympathetic nervous system, the heart rate increases and the temper becomes irritable. Older children often feel palpitations, and in severe cases, arrhythmias and atrial fibrillation may occur. There are often subtle and rapid tremors in both hands.

2. All children have thyroid enlargement

The degree of swelling varies, and is generally symmetrical on both sides. It has a soft texture and a smooth surface, with clear boundaries, and can move up and down with swallowing. A systolic murmur may sometimes be heard or a thrill may be felt over an enlarged thyroid gland. Nodular swelling can be felt as single or multiple nodules of varying sizes, hard texture. Sometimes patients experience discomfort and pressure in the neck, difficulty swallowing, and may have slow puberty, menstrual disorders, amenorrhea, and oligomenorrhea.

3. Eye changes

Eye signs are unique manifestations of hyperthyroidism. Due to the protruding eyeballs, the patient often stares and rarely blinks. The upper eyelid is contracted and cannot fall immediately with the eyeball when the eye looks downward, and it is difficult to evert the upper eyelid. Eye signs also include widening of the palpebral fissure, eyelid edema, conjunctival edema, corneal congestion, etc.

4. Others

There may be slow puberty development, menstrual disorders, amenorrhea and oligomenorrhea.

Hyperthyroidism Treatment

1. General treatment

Students should take a rest during illness and can be exempted from physical education classes. Avoid external stimulation and pressure, and the diet should be rich in protein, carbohydrates, vitamins, etc.

2. Methimazole (also known as methimazole)

This drug can inhibit the combination of iodine and tyrosine and inhibit the synthesis of thyroid hormones. It takes effect quickly and lasts a long time after oral administration (half-life is 6-8 hours). After 1-3 months of medication, the condition is basically under control, the heart rate drops to 80-90 beats/min, and blood T3 and T4 also drop to normal. The dosage can be reduced by 1/3 to 1/2. If it is still stable, gradually reduce to the maintenance dose. Generally, it is appropriate to use the drug for 2-3 years. A small number of children may develop temporary leukopenia or rash after taking the medicine, which disappears as soon as the medicine is stopped. In severe cases, granulocytopenia, liver damage, glomerulonephritis and vasculitis may occur. Although these are rare, careful observation is still required during use. Agranulocytosis often occurs in the first few weeks or months of medication, often accompanied by fever. Therefore, blood routine tests should be checked frequently during the initial treatment. If the white blood cell count is lower than 4×109/L, antithyroid drugs should be reduced or stopped, and white blood cell-raising drugs (such as shark liver alcohol, reserpine, moraspomicin, etc.) should be given to treat the rash. Generally, the condition can be improved through treatment with anti-allergic drugs such as diphenhydramine, chlorpheniramine (chlorpheniramine), astemizole (assetamine), etc. For severe rashes, glucocorticoids can be tried.

3. Propylthiouracil (PTU)

In addition to inhibiting the synthesis of thyroid hormones, it also reduces the conversion of T4 into T3 in peripheral tissues, and its toxicity is the same as that of methimazole. After being absorbed, propylthiouracil (PTU) mostly binds to proteins in the blood circulation and rarely passes through the placenta, so it will not harm the fetus.

4. Propranolol

If the cardiovascular symptoms are obvious, the adrenergic receptor blocker propranolol (Inderal) can be added as an auxiliary drug to alleviate symptoms such as rapid heart rate, sweating, tremor, etc. caused by excessive excitement of the sympathetic nerves.

5. Thyroid powder (tablets)

If hypothyroidism, thyroid enlargement or more obvious exophthalmos occurs during the treatment, thyroid powder should be added and the dosage of methimazole (thimazole) should be reduced as appropriate.

6. Surgery

Thyroid surgery is indicated for patients with drug allergies, granulocytopenia, thyroid tumors, significantly enlarged thyroid gland that does not shrink significantly after taking medication, or recurrence of the disease after taking medication. Antithyroid drugs are used for 2-3 months before surgery to normalize thyroid function. Take iodine/potassium iodide (compound iodine solution) for 1 to 2 weeks before surgery to prevent intraoperative bleeding. From 4 days before surgery to 7 days after surgery, take propranolol (Inderal) orally once every 6 hours. The incidence of hypothyroidism after surgery is 50%, and a few cases experience temporary or permanent hypoparathyroidism.

7. Radionuclide iodine therapy

Recently, many scholars have recommended the use of radionuclide iodine to treat hyperthyroidism, believing that it is simple, effective, economical and has no carcinogenic risk. After treatment, the thyroid gland can shrink by 35%-54%, but the long-term incidence of hypothyroidism can be as high as 92%.

8. Neonatal hyperthyroidism

For mild cases, no medication is needed. For obvious symptoms, propylthiouracil can be used. For severe cases, propranolol (Inderal) and symptomatic treatment can be added. If necessary, intravenous infusion, antibiotics and corticosteroids can be added.

9. Treatment of hyperthyroid crisis

Hyperthyroid crisis is extremely rare in children. The causes include: infection, fatigue, inadequate preparation before surgery, mental trauma, etc. Symptoms may include high fever, rapid pulse, irritability, heavy sweating, vomiting and diarrhea. Severe cases may be accompanied by shock. Treatment should include large amounts of iodine given orally and intravenously, Lugol's solution given orally, NaI added to glucose saline and injected intravenously. Propylthiouracil should be taken 1 hour before iodine administration (it can reduce the conversion of T4 to T3 in peripheral tissues, so it is better than methimazole in critical conditions) and taken every 6 hours. Propranolol (Inderal) is slowly pushed intravenously for oxygen inhalation, fever reduction and sedation, infection control, intravenous hydrocortisone is added, and digitalis is used to control heart failure when necessary.