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Updated: Aug 2, 2025

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Suicide Attempt With Levothyroxine Overdose.

Angad S Gill1, Harpreet K Rai2, Abhijana Karunakaran2

  • 1Internal Medicine, Griffin Hospital, Derby, USA.

Cureus
|April 17, 2023
PubMed
Summary
This summary is machine-generated.

Levothyroxine overdose, even up to 9 mg, may not cause immediate symptoms. Close monitoring and treatments like propranolol and cholestyramine are recommended for managing levothyroxine toxicity.

Keywords:
drug overdoselevothyroxinelevothyroxine overdoselevothyroxine poisoningpoisoningthyroid hormone overdose

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Area of Science:

  • Endocrinology
  • Clinical Toxicology

Background:

  • Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism.
  • Levothyroxine overdose management lacks specific guidelines.
  • Patient presented with a history of panhypopituitarism, hypertension, and end-stage renal disease.

Observation:

  • A 69-year-old male ingested 9 mg of levothyroxine in a suicide attempt.
  • Initially asymptomatic despite supranormal free thyroxine levels.
  • Developed sinus tachycardia, mild liver enzyme elevations during hospitalization.

Findings:

  • Thyroid hormone levels normalized in 20 days with supportive care.
  • The body has compensatory mechanisms for levothyroxine toxicity.
  • Asymptomatic presentation is possible even with significant overdose.

Implications:

  • Close patient observation is crucial, as symptoms may be delayed.
  • Effective treatments include beta-blockers (propranolol), gastric lavage, cholestyramine, and glucocorticoids.
  • Hemodialysis has limited efficacy; antithyroid drugs and activated charcoal are ineffective.