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Factitious hyperthyroidism
Factitious thyrotoxicosis; Thyrotoxicosis factitia; Thyrotoxicosis medicamentosa
Factitious hyperthyroidism is higher-than-normal thyroid hormone levels in the blood that occur from taking too much thyroid hormone medicine.
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.
Hyperthyroidism
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.
Hyperthyroidism can also be caused by taking too much thyroid hormone medicine for hypothyroidism . This is called factitious hyperthyroidism. When this occurs because the prescribed dosage of hormone medicine is too high, it is called iatrogenic, or doctor-induced, hyperthyroidism.
Hypothyroidism
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. This condition is often called underactive thyroid....
Factitious hyperthyroidism can also occur when someone takes too much thyroid hormone on purpose. These may be people:
-
Who have mental disorders such as
Munchausen syndrome
Munchausen syndrome
Munchausen syndrome by proxy is a mental illness and a form of child abuse. The caretaker of a child, most often a mother, either makes up fake symp...
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- Who want to get money from the insurance company
Children may take thyroid hormone pills accidentally.
In rare cases, factitious hyperthyroidism is caused by eating meat that has thyroid gland tissue in it.
Symptoms
The symptoms of factitious hyperthyroidism are the same as those of hyperthyroidism caused by a thyroid gland disorder, except that:
-
There is no
goiter
. The thyroid gland is often small.
Goiter
A simple goiter is an enlargement of the thyroid gland. It is usually not a tumor or cancer.
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The eyes do not bulge, as they do in
Graves disease
(the most common type of hyperthyroidism).
Graves disease
Graves disease is an autoimmune disorder that leads to an overactive thyroid gland (hyperthyroidism). An autoimmune disorder is a condition that occ...
ImageRead Article Now Book Mark Article - The skin over the shins does not thicken, as it sometimes does in people who have Graves disease.
Exams and Tests
Blood tests used to diagnose factitious hyperthyroidism include:
- Free T4
-
Radioactive iodine uptake
Radioactive iodine uptake
Radioactive iodine uptake (RAIU) tests thyroid function. It measures how much radioactive iodine is taken up by your thyroid gland in a certain time...
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-
Total
T3
T3
Triiodothyronine (T3) is a thyroid hormone. It plays an important role in the body's control of metabolism (the many processes the body does to func...
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Total
T4
T4
T4 (thyroxine) is the main hormone produced by the thyroid gland. A laboratory test can be done to measure the amount of free T4 in your blood....
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TSH
TSH
A TSH test measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland. It tells the thyroid gla...
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Treatment
Your health care provider will tell you to stop taking thyroid hormone. If you need to take it, your provider will reduce the dosage.
You should be re-checked in 2 to 4 weeks to be sure that the signs and symptoms are gone. This also helps to confirm the diagnosis.
People with Munchausen syndrome will need mental health treatment and follow-up.
Outlook (Prognosis)
Factitious hyperthyroidism will clear up on its own when you stop taking or lower the dosage of thyroid hormone.
Possible Complications
When factitious hyperthyroidism lasts a long time, the same complications as untreated or improperly treated hyperthyroidism may develop:
-
Abnormal heartbeat (
atrial fibrillation
)
Atrial fibrillation
Atrial fibrillation or flutter is a common type of abnormal heartbeat. The heart rhythm is fast and most often irregular.
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Chest pain
(
angina
)
Chest pain
Chest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.
ImageRead Article Now Book Mark ArticleAngina
Angina is a type of chest discomfort or pain due to poor blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium). Th...
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Heart attack
Heart attack
Most heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. ...
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Loss of bone mass (if severe,
osteoporosis
)
Osteoporosis
Osteoporosis is a disease in which bones become fragile and more likely to break (fracture).
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Weight loss
Weight loss
Unexplained weight loss is a decrease in body weight, when you did not try to lose the weight on your own. Many people gain and lose weight. Uninten...
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When to Contact a Medical Professional
Contact your provider if you have symptoms of hyperthyroidism.
Prevention
Thyroid hormone should be taken only by prescription and under the supervision of a provider.
References
Davies TF, Laurberg P, Bahn RS. Hyperthyroid disorders. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology . 13th ed. Philadelphia, PA: Elsevier; 2016:chap 12.
Kopp P. Autonomously functioning thyroid nodules and other causes of thyrotoxicosis. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 85.
-
Thyroid gland - illustration
The thyroid gland, a part of the endocrine (hormone) system, plays a major role in regulating the body's metabolism.
Thyroid gland
illustration
Review Date: 5/20/2016
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
