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    Factitious hyperthyroidism

    Factitious thyrotoxicosis; thyrotoxicosis factitia; thyrotoxicosis medicamentosa

    Factitious hyperthyroidism is higher-than-normal thyroid hormone levels in the bloodthat occur from taking too much thyroid hormone medication.

    Causes

    The thyroid gland produces the hormones thyroxine (T4) and triiodothyronine (T3). In most cases of hyperthyroidism, the thyroid gland itself produces too much of these hormones.

    However, hyperthyroidism can also be caused by taking too much thyroid hormone medication for hypothyroidism. This is called factitious hyperthyroidism. When this occurs because the prescribed dose of hormone medication is too high, it is called iatrogenic, or "doctor-induced," hyperthyroidism.

    Factitious hyperthyroidism can also occur when a patient intentionally takes too much thyroid hormone, such as in people:

    • Who have psychiatric disorders such as Munchausen syndrome
    • Who are trying to lose weight
    • Who want to get compensation from the insurance company

    Children may take thyroid hormone pills accidentally.

    In rare cases, factitious hyperthyroidism is caused by eating meat contaminated with thyroid gland tissue.

    Symptoms

    The symptoms of factitious hyperthyroidism are the same as those of hyperthyroidism caused by the thyroid gland, except that:

    • There is no goiter. The thyroid gland is usually small.
    • The eyes do not bulge, as they do in Graves disease (the most common type of hyperthyroidism).
    • The skin over the shins does not thicken, as itsometimes doesin people who have Graves disease.

    Exams and Tests

    Tests used to diagnosefactitious hyperthyroidism include:

    • Free T4
    • Radioactive iodine uptake
    • Thyroglobulin
    • Total T3
    • Total T4
    • TSH

    Treatment

    You must stop taking thyroid hormone. If you need to take this medicine, you will need to reduce the dose.

    You should be re-checked in 2 - 4 weeks to be sure that the signs and symptoms of hyperthyroidism are gone. This also helps to confirm the diagnosis.

    People with Munchausen syndrome will needmental healthtreatment and follow-up.

    Outlook (Prognosis)

    Factitious hyperthyroidism will clear up on its own when you stop taking or lower the dose of thyroid hormone.

    Possible Complications

    When factitious hyperthyroidism lasts a long time, patients are at risk for the same complications of untreated or improperly treated hyperthyroidism caused by the thyroid gland.

    These complications include:

    • Atrial fibrillation
    • Chest pain (angina)
    • Heart attack
    • Irregular heart rhythm
    • Loss of bone mass (if severe, osteoporosis)
    • Weight loss

    When to Contact a Medical Professional

    Contact your health care provider if you experience any of the symptoms of hyperthyroidism.

    Prevention

    Thyroid hormone should be taken only by prescription and under the supervision of a licensed physician.

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    • Thyroid gland

      illustration

      • Thyroid gland

        illustration

      Tests for Factitious hyperthyroidism

        Review Date: 6/4/2012

        Reviewed By: Shehzad Topiwala, MD, Chief Consultant Endocrinologist, Premier Medical Associates, The Villages, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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