Thyrotoxicosis Insistiates: Report of 17 Cases
Authors: Steven Snyder
Journal: Annals of Internal Medicine (1997)

Letters1 July 1997Thyrotoxicosis Insistiates: Report of 17 CasesSteven Snyder, MD and Marc Jaffe, MDSteven Snyder, MDKaiser Permanente Medical Center; South San Francisco, CA 94080Search for more papers by this author and Marc Jaffe, MDKaiser Permanente Medical Center; South San Francisco, CA 94080Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-1-199707010-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Although thyrotoxicosis secondary to the ingestion of excess thyroid hormone (thyrotoxicosis medicamentosa or thyrotoxicosis factitia) has been well documented [1], no previous reports have described patients who insist that their physician prescribe thyroid hormone replacement therapy (THRT) that results in consistently undetectable serum thyroid-stimulating hormone (TSH) levels (sensitivity of assay, 0.002 µU/mL).We have found 17 patients with thyrotoxicosis insistiates (Latin for “thyrotoxicosis having been demanded or insisted”) followed by endocrinologists in our large health maintenance organization. Most of the patients began receiving THRT by fee-for-service physicians in the early 1970s before joining our health maintenance organization. ...References1. Cohen JH III, Ingbar SH, Braverman LE. Thyrotoxicosis due to ingestion of excess thyroid hormone. Endocrinol Rev. 1989; 10:1133-24. Google Scholar2. Carr D, McLeod DT, Parry G, Thornes HM. Fine adjustment of thyroxine replacement dosage: comparison of the thyrotrophin releasing hormone test using a sensitive thyrotrophin assay with measurement of free thyroid hormone and clinical assessment. Clin Endocrinol (Oxf). 1988; 28:325-33. Google Scholar3. Goodwin FK, Prange AJ Jr. Potentiation of antidepressant effects by L-triidothyronine in tricyclic nonresponders. Am J Psychiatr. 1982; 139:34-8. Google Scholar4. Gupta S, Masand P, Tanquary JF. Thyroid hormone supplementation of fluoxetine in the treatment of major depression. Br J Psychiatr. 1991; 159:866-7. Google Scholar5. Larsen RP. Thyroid pituitary interaction: feedback regulation of thyrotrophin secretion by thyroid hormones. N Engl J Med. 1982; 306:23-32. Google Scholar Author, Article, and Disclosure InformationAffiliations: Kaiser Permanente Medical Center; South San Francisco, CA 94080 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoInternet-Enabled Thyroid Hormone Abuse Gerald W. Neuberg , Kathryn E. Stephenson , David A. Sears , and Robert J. McConnell Metrics Cited byThe diagnostic dilemma of pathological appearance and performance enhancing drug useInternet-Enabled Thyroid Hormone AbuseGerald W. Neuberg, MD, Kathryn E. Stephenson, MD, MPH, David A. Sears, MD, and Robert J. McConnell, MD 1 July 1997Volume 127, Issue 1Page: 88KeywordsHealth maintenance organizationsIngestionOsteoporosisPituitary glandTachycardiaThyroidThyroid hormonesThyroid-stimulating hormoneThyroxineTriiodothyronine Issue Published: 1 July 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...