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Iatrogenic hyperthyroidism secondary to dextrothyroxine administration.

J H Hankins, C M Heise, R J Cowan

    Clinical Nuclear Medicine
    |January 1, 1984
    PubMed
    Summary
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    Chronic ingestion of D-thyroxine (D-T4) can cause hyperthyroidism with low radioactive iodine uptake. Discontinuing D-T4 reversed these effects, highlighting its potential prevalence.

    Area of Science:

    • Endocrinology
    • Thyroidology

    Background:

    • Thyroid hormone replacement therapy is common.
    • Levothyroxine (L-T4) is the standard treatment.
    • Dextrothyroxine (D-T4) is a less common isomer.

    Observation:

    • Two patients presented with clinical hyperthyroidism.
    • Elevated serum thyroid function tests were observed.
    • Radioactive iodine uptake was significantly depressed.

    Findings:

    • Both patients had a history of chronic D-T4 ingestion.
    • Discontinuation of D-T4 led to symptom resolution.
    • Thyroid function studies normalized after D-T4 cessation.

    Implications:

    • D-T4 ingestion is a potential cause of suppressed radioiodine uptake in hyperthyroid patients.

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  • This diagnosis should be considered in cases of unexpected low uptake.
  • Increased awareness may improve diagnostic accuracy for thyroid disorders.