Abstract：Hyperthyroidism（HT）is a common endocrine metabolic disease that can lead to various complications. Explores the syndrome differentiation and treatment of HT based on defense， qi， nutrient and blood theory， considering its etiology， pathogenesis， and disease progression. The theory divides the disease development process into four stages：defense，qi，nutrient and blood. Defense aspect syndrome：At the onset of warm disease，pathogenic factors invade the skin and surface， disrupting defense qi and causing abnormal defense functions. Clinical manifestations include fever，aversion to cold，and thirst，which are consistent with the initial symptoms of HT. The treatment principle is to release the exterior with acrid-cool herbs and vent pathogen and clear heat，commonly using Yinqiao Powder. Qi aspect syndrome： The pathogenic factors penetrate deeper， transforming into heat， leading to intense struggle between pathogenic and healthy qi. Clinical manifestations include high fever，vexing thirst，and red tongue with yellow coating， corresponding to the high metabolic syndrome stage of HT. The treatment principle is to clear heat and resolve toxins， commonly using prescriptions like Baihu Decoction. Nutrient aspect syndrome： The pathogenic factors further invade the nutrient yin，disturbing the mind. Clinical manifestations include fever worsening at night，vexation，insomnia，and delirium，which align with the thyroid crisis of HT. The treatment principle is to enrich and nourish the nutrient yin， vent heat， commonly using Qingying Decoction. Blood aspect syndrome： The pathogenic factors invade the yin blood， causing excessive heat and blood movement. Clinical manifestations include bleeding tendencies and mental disturbances， similar to the late-stage symptoms of HT. The treatment principle is to clear heat，cool blood，invigorate blood，and dispel stasis，commonly using Xijiao Dihuang Decoction.