Related Experiment Videos
[Pseudomalabsorption of levothyroxine: a case report]
William Pedrosa1, Geraldo Santana
1Instituto Mineiro de Endocrinologia, Rua Tomé de Souza 830, 30140-131 Belo Horizonte, MG. wp@endocrinologia.com.br
Arquivos Brasileiros De Endocrinologia E Metabologia
|September 27, 2005
Summary
Persistent hypothyroidism in a patient despite high-dose levothyroxine treatment was investigated. The study considered factitious disorder and Munchausen syndrome, suggesting pseudomalabsorption of thyroid hormone.
Area of Science:
- Endocrinology
- Thyroidology
- Psychiatry
Background:
- A patient with hypothyroidism secondary to Hashimoto thyroiditis and total thyroidectomy presented with persistent symptoms despite high-dose levothyroxine therapy.
- Standard laboratory tests indicated severe hypothyroidism, with elevated TSH and low free thyroxine levels.
Observation:
- The patient underwent a levothyroxine overload test under medical supervision.
- This test revealed no evidence of gastrointestinal malabsorption of the administered thyroid hormone.
Findings:
- Despite documented high-dose levothyroxine intake and normal absorption, the patient exhibited persistent hypothyroidism.
- This clinical presentation raised suspicion for non-organic causes of apparent levothyroxine malabsorption.
Implications:
- The findings suggest the possibility of factitious disorder or Munchausen syndrome as underlying causes.
- This case highlights the importance of considering psychological factors in refractory hypothyroidism and apparent medication non-response.
- Further investigation into behavioral and psychological aspects is warranted for accurate diagnosis and management.