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A 'Natural' thyroid storm!

Mohammad Reza Mohebbi1, Alexander T Chen2

  • 1Department of Emergency Medicine, St Joseph's Medical Center, Stockton, California.

Journal of Clinical Pharmacy and Therapeutics
|June 19, 2019
PubMed
Summary
This summary is machine-generated.

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Over-the-counter thyroid supplements can cause dangerous thyrotoxicosis, as seen in a patient with refractory atrial fibrillation. These unregulated supplements require FDA oversight due to inconsistent and potentially harmful dosages.

Area of Science:

  • Endocrinology
  • Pharmacology
  • Emergency Medicine

Background:

  • Over-the-counter (OTC) supplements are frequently overlooked during emergency department medication reconciliation.
  • Dietary supplements, including thyroid extracts, are not regulated by the U.S. Food and Drug Administration (FDA).
  • Some OTC supplements pose significant health risks and can interact with prescribed medications.

Observation:

  • A case of thyrotoxicosis was identified, stemming from the ingestion of OTC bovine thyroid supplements.
  • The patient presented with atrial fibrillation exhibiting a rapid ventricular response that was resistant to standard calcium channel blocker treatment.
  • The clinical team's awareness of the bovine thyroid supplement was crucial for appropriate management.

Findings:

Keywords:
OTCcardiovascular diseaseclinical pharmacokineticscliniciansover-the-counter medicationssupplementthyroid

Related Experiment Videos

  • OTC thyroid supplements are marketed without robust regulatory oversight.
  • Analysis of thyroid extracts reveals significant variability in composition, with doses ranging from none to excessively high levels.
  • The patient's thyrotoxicosis was directly linked to the unregulated bovine thyroid supplement intake.

    • Implications:

    • The lack of regulation for natural thyroid supplements poses a public health concern.
    • Inconsistent dosing in unregulated thyroid extracts can lead to severe adverse events like thyrotoxicosis.
    • There is a critical need for regulatory scrutiny of thyroid supplements to ensure patient safety and prevent potentially dangerous outcomes.