Thyrotoxicosis after massive triiodothyronine (LT3) overdose: a coast-to-coast case series and review

Drugs in Context

article

Zhiheng H He¹  Yan Li³  Nitin Trivedi³  Sabrina Gill⁴  James V Hennessey² 

[1] Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, Cambridge Health Alliance;Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School;Department of Medicine, St. Vincent Hospital;Division of Endocrinology & Metabolism, Department of Medicine, St. Paul’s Hospital, University of British Columbia

关键词: compounding;    hyperthyroidism;    hypothyroidism;    iatrogenic;    LT3;    thyrotoxicosis;    triiodothyronine;   

DOI  :  10.7573/dic.2019-8-4

学科分类：社会科学、人文和艺术（综合）

来源: C S F Medical Communications Ltd.

【 摘 要 】

Excessive exogenous thyroid hormone ingestion may lead to severe thyrotoxicosis and cause potential harm. We have reviewed the literature and suggested that thyroid hormone supplementation should not be used to alleviate nonspecific complaints in patients with normal endogenous thyroid function. Failure to do so may cause serious harm, as demonstrated in one of the cases described here. In addition, treatment based on symptom relief only without biochemical measure may lead to overmedication – as reported from academic hospitals both in Canada and the United States. Given the risk of severe thyrotoxicosis from potential compounding errors, pharmacies providing a compounding service should be subject to more rigorous monitoring by the food and drug administration. Clinicians should also use local biochemical markers when titrating thyroid hormone supplements even though the normal thyroid function reference range has its limitation, failure to do so may result in iatrogenic thyrotoxicosis.

【 授权许可】

CC BY-NC-ND