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Chen Xie
Endocrinology
About me
Loudi Central Hospital, Endocrinology Department, attending physician, has been engaged in clinical work in endocrinology for many years, with rich clinical experience in the diagnosis and treatment of endocrine system diseases.
Proficient in diseases
Specialize in common diseases related to the hypothalamus, pituitary gland, thyroid gland, parathyroid glands, adrenal glands, and the reproductive axis.
Voices
What is hypoglycemia?
Hypoglycemia is a condition characterized by abnormally low plasma glucose levels, caused by various etiologies, and clinically presents as a syndrome mainly featuring sympathetic nervous excitement and brain cell glucose deficiency. For healthy individuals, hypoglycemia is diagnosed when blood glucose levels fall below 2.8 mmol/L. For diabetic patients, hypoglycemia is diagnosed when blood glucose levels are below 3.8 mmol/L. Hypoglycemia can be categorized into fasting hypoglycemia and postprandial hypoglycemia based on its causes. Common symptoms of hypoglycemia include palpitations, fatigue, trembling hands, accelerated heart rate, sweating, mental distraction, dizziness, drowsiness, unstable gait, irritability, and even odd behaviors. In severe cases, it can lead to coma or even death.
Effects of gestational diabetes on the fetus
The impact of gestational diabetes on the fetus mainly manifests in early stages as spontaneous miscarriage, fetal malformations, and abnormal fetal development. As the fetus grows, the high maternal blood sugar levels can lead to a large fetus, which increases the risk of birth injuries during delivery. Due to the high insulin levels in the mother, the fetus may have hyperinsulinemia, which can cause recurrent hypoglycemia at birth. Additionally, the development and maturation of the fetal lungs are delayed, making the newborn more susceptible to respiratory distress syndrome. Furthermore, gestational diabetes also increases the risk of preterm birth.
Does thyroiditis hurt?
The most common causes of thyroiditis refer to subacute thyroiditis and autoimmune thyroiditis. Subacute thyroiditis is mainly caused by viral infection, leading to the destruction of thyroid follicular cells. This generally results in pain in the thyroid region, which can even radiate to areas like the back of the neck and ears, with the pain symptoms being relatively significant. Meanwhile, Hashimoto's thyroiditis typically does not present with pain, although a small number of patients may experience localized pain during the onset of the disease, but the symptoms are usually mild. Additionally, the pain in the neck thyroid region associated with subacute thyroiditis varies from person to person, with varying degrees of pain intensity. It is primarily treatable with steroids or non-steroidal anti-inflammatory drugs, and generally, the symptoms can be relieved after treatment.
Does Hashimoto's thyroiditis cause fever?
Hashimoto's thyroiditis belongs to autoimmune thyroiditis, where the body's own antibodies destroy the thyroid follicular cells, leading to apoptosis of thyroid cells. As the disease progresses, it may lead to hypothyroidism. Generally, Hashimoto's thyroiditis does not cause fever. If a patient with Hashimoto's thyroiditis experiences a fever, it is necessary to exclude other infectious diseases. If a patient with Hashimoto's thyroiditis has a fever, especially if there is significant tenderness in the thyroid area, it is necessary to exclude the possibility of concomitant subacute thyroiditis. If Hashimoto's thyroiditis is accompanied by subacute thyroiditis, small doses of hormones can be used for treatment. (Please use medication under the guidance of a doctor.)
Re-examination of thyroiditis includes checking for what?
Thyroiditis includes autoimmune thyroiditis and subacute thyroiditis. For patients with subacute thyroiditis, it is recommended to check thyroid function, erythrocyte sedimentation rate, and complete blood count among others to understand the control of the infection and the status of thyroid function. For autoimmune thyroiditis, it is advised to check thyroid function as well as thyroperoxidase antibodies and thyroglobulin antibodies to understand the function of the thyroid and the related antibody status. Additionally, a re-examination of thyroid ultrasound is recommended to assess the condition of the thyroid.
Treatment of Hyperuricemia with Medication
The treatment of hyperuricemia primarily involves dietary control, focusing on low-purine foods, increasing water intake, and maintaining regular exercise. Additionally, alkalizing the urine using sodium bicarbonate to keep the urine pH between 6.2 and 6.9 can help facilitate the excretion of uric acid. It's also important to avoid medications that can increase uric acid levels. For reducing uric acid, treatments mainly include probenecid, which can increase the excretion of uric acid, and febuxostat, an alternative to allopurinol, though side effects of these medications should be noted. Therefore, it is advised for patients with hyperuricemia to consult a doctor at a reputable hospital before taking any medications.
What are the clinical manifestations of thyroid cancer?
For patients with thyroid cancer, the most common clinical manifestation is thyroid nodules, and most patients do not have obvious clinical symptoms, only being incidentally discovered during physical examinations. In rare cases, patients may seek medical attention due to enlarged cervical lymph nodes. As the condition progresses, the neck mass gradually enlarges, becomes firmer, and its mobility decreases during swallowing. In some rapid developments, it may invade surrounding tissues, leading to late-stage symptoms such as hoarseness, difficulty breathing, and difficulty swallowing. When the cervical sympathetic nerve is compressed, it can cause pain in the ears, occipital region, and shoulders. In the case of medullary carcinoma, which can produce serotonin and calcitonin, patients may sometimes experience symptoms such as diarrhea, palpitations, facial flushing, or decreased blood calcium levels.
How to cure Hashimoto's thyroiditis?
Hashimoto's thyroiditis is characterized by autoimmune antibodies destroying the thyroid gland, leading to a gradual decline in thyroid function and manifesting symptoms of hypothyroidism. Currently, this disease is incurable. Treatment mainly includes restricting iodine intake to keep it within a safe range to prevent the progression of autoimmune destruction of the thyroid. Patients who only have thyroid swelling without hypothyroidism generally do not require treatment. However, once hypothyroidism occurs, it can be treated with levothyroxine to alleviate the symptoms of hypothyroidism. Nevertheless, current levothyroxine treatment cannot stop the progression of the disease. When the thyroid swells rapidly with local pain or compressive symptoms, treatment with glucocorticoids can be considered. However, if the symptoms do not improve or the compressive symptoms are significant, surgical treatment may be considered, although the likelihood of developing hypothyroidism post-surgery is higher.
What kind of salt should be consumed for Hashimoto's thyroiditis?
Hashimoto's thyroiditis is a type of autoimmune thyroiditis that can manifest as hyperthyroidism, hypothyroidism, or normal thyroid function during its progression. Therefore, there are different requirements for the type of salt to consume depending on the state of thyroid function. When Hashimoto's thyroiditis presents with hyperthyroidism, it is recommended to consume non-iodized salt. When thyroid function is normal in Hashimoto's thyroiditis, iodized salt can be consumed. When Hashimoto's thyroiditis is accompanied by hypothyroidism, there is no specific requirement for consuming iodized or non-iodized salt. Because at this stage, the thyroid has largely lost its ability to synthesize thyroid hormones, and treatment involves replacing them with levothyroxine to maintain thyroid function. Therefore, the intake of iodine does not matter, and one can freely choose to consume iodized or non-iodized salt. Thus, the choice of salt in Hashimoto's thyroiditis should be based on thyroid function testing.
Is Hashimoto's thyroiditis hereditary?
Hashimoto's thyroiditis is an autoimmune thyroid disease and is not hereditary. However, it tends to cluster in families, meaning if one's parents have a history of Hashimoto's thyroiditis, their offspring have a relatively higher risk of developing the disease. However, this is not absolute heredity; it simply indicates a familial clustering tendency. Treatment for Hashimoto's thyroiditis is relatively effective. If hypothyroidism occurs, one only needs to take lifelong replacement therapy with levothyroxine to maintain thyroid function within the normal range, which has minimal impact on the body. Therefore, there is no need for excessive worry.