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Internet-Enabled Thyroid Hormone Abuse
- Gerald W. Neuberg, MD;
- Kathryn E. Stephenson, MD, MPH;
- David A. Sears, MD; and
- Robert J. McConnell, MD
- From Columbia University College of Physicians and Surgeons, New York, NY 10032.
Background: Patients increasingly use the Internet for health information and services, including the convenient purchase and delivery of prescription drugs.
Objective: To present a case of life-threatening thyroid hormone abuse, encouraged and enabled by unconventional health advice and nonprescribed medication obtained via the Internet.
Case Report: A 56-year-old woman presented to the emergency department with dyspnea and palpitations. Eight years earlier, she underwent thyroidectomy for hyperthyroidism. After thyroidectomy, she took l-thyroxine but struggled with fatigue and weight gain. She saw 5 endocrinologists and tried various regimens but continued to feel weak and “not herself.” She lost her job, got divorced, and became depressed; fluoxetine did not help her symptoms.
A patient-directed Web site called Stop the Thyroid Madness (1) convinced her to take Armour Thyroid (desiccated porcine thyroxine [T4] and triiodothyronine [T3]; Forest Laboratories, New York, New York) in doses high enough to …
