The condition may be self-induced. Dosage should be reduced or therapy temporarily discontinued if signs and symptoms of overdosage appear. Treatment may be reinstituted at a lower dosage. Treatment of acute massive thyroid hormone overdosage is aimed at reducing gastrointestinal absorption of the drug and counteracting central and peripheral effects, mainly those of increased sympathetic activity. Vomiting may be induced initially if further gastrointestinal absorption can reasonably be prevented and barring contraindications such as coma, convulsions or loss of the gagging reflex.
Treatment is symptomatic and supportive.
Oxygen may be administered and ventilation maintained. Cardiac glycosides may be indicated if congestive heart failure develops. Measures to control fever, hypoglycemia or fluid loss should be instituted if needed. Antiadrenergic agents, particularly propranolol, have been used advantageously in the treatment of increased sympathetic activity. Other adjunctive measures may include administration of cholestyramine to interfere with thyroxine absorption and glucocorticoids to inhibit conversion of T4 to T3.