Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Pseudomalabsorption of levothyroxine: a case report.

D Ogawa1, F Otsuka, U Mimura

  • 1Department of Medicine III, Okayama University Medical School, Japan.

Endocrine Journal
|May 16, 2000
PubMed
Summary

This study describes a patient with persistent hypothyroidism despite high-dose levothyroxine sodium treatment. Researchers identified "pseudomalabsorption" as the cause, highlighting the need for clinical recognition in resistant hypothyroidism cases.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Comprehensive analysis of gene expressions in ileal mucosa of chickens fed paddy rice and their IgA response to oral vaccination.

Poultry science·2025
Same author

Association of subpleural ground-glass opacities with respiratory failure and RNAemia in COVID-19.

European radiology·2023
Same author

Epstein-Barr virus-associated inflammatory pseudotumor variant of follicular dendritic cell sarcoma of the liver: a case report and review of the literature.

Surgical case reports·2022
Same author

Gastrointestinal: Pembrolizumab-induced gastric ulcer occurring as an immune-related adverse event.

Journal of gastroenterology and hepatology·2022
Same author

Clinic-level factors associated with collaboration with community pharmacies in Japan.

Die Pharmazie·2018
Same author

Ingestion of paddy rice increases intestinal mucin secretion and goblet cell number and prevents dextran sodium sulfate-induced intestinal barrier defect in chickens.

Poultry science·2018

Area of Science:

  • Endocrinology
  • Pharmacology
  • Internal Medicine

Background:

  • Levothyroxine sodium is the standard treatment for hypothyroidism following thyroidectomy for thyroid cancer.
  • Patients may present with persistent hypothyroidism despite seemingly adequate or high-dose oral levothyroxine therapy.
  • Factitious disorder can complicate the diagnosis and management of endocrine conditions.

Observation:

  • A 51-year-old woman with hypothyroidism post-thyroidectomy presented with severe fatigue and weight gain despite receiving 600 mcg/day of levothyroxine.
  • Laboratory results showed suppressed TSH with low free T4 and free T3 levels, indicating inadequate thyroid hormone replacement.
  • Levothyroxine loading tests via various routes (liquid, crushed tablets, IV) ruled out malabsorption or metabolic issues.

Findings:

Related Experiment Videos

  • The patient's condition was attributed to factitious administration of levothyroxine, leading to "pseudomalabsorption."
  • This phenomenon mimics true malabsorption but is caused by intentional non-adherence or manipulation of medication intake.
  • Diagnostic challenges arise when patients present with symptoms of hypothyroidism despite documented high-dose medication use.

Implications:

  • Recognizing "pseudomalabsorption" is crucial for managing patients with apparent resistant hypothyroidism.
  • Clinicians should consider factitious disorders in cases of unexplained treatment failure.
  • This case underscores the importance of a comprehensive diagnostic approach, including behavioral and psychological assessments, in complex endocrine management.