SHM Converge Scientific Abstract ePoster Gallery-Supplement-Induced Thyrotoxicosis: An Unexpected Endocrine Storm

Pdf Summary

This case highlights a rare but important adverse effect of over-the-counter supplements: supplement-induced thyrotoxicosis. A 49-year-old woman presented with three weeks of lower-extremity edema, abdominal distention, weight loss, and severe sinus tachycardia. On exam, she appeared cachectic and had signs of volume overload, including jugular venous distention, hepatojugular reflux, bilateral lower lung rales, ascites, and bilateral pitting edema. She also had right-sided thyroid enlargement.<br /><br />Her workup showed thyroid abnormalities consistent with hyperthyroidism, and she had recently started care with a functional medicine provider who prescribed multiple supplements. Review of the supplement labels revealed that one contained thyroid hormone (thyroidinum). She was treated with a beta-blocker and propylthiouracil, later transitioned to methimazole.<br /><br />The discussion emphasizes that adverse events from supplements are not rare overall, accounting for more than 23,000 emergency department visits and over 2,100 hospitalizations each year. These events can present in many ways and may be especially dangerous in patients with underlying disease. Although supplement-induced thyrotoxicosis is uncommon, it has been reported in weight-loss products and alternative medicines. In this patient, the supplement appears to have unmasked and worsened previously undiagnosed Graves’ disease.<br /><br />The key clinical takeaway is to always ask patients about all supplements they are taking and consider them as potential contributors to unexplained symptoms.

Asset Subtitle

Evan Parsley

Meta Tag

Author List Cole J. White, Evan Parsley

Category Clinical Vignettes

Concept Over-the-Counter Supplement

Concept Supplement-Induced Thyrotoxicosis

Concept Thyrotoxicosis

Concept Supplement Use

Concept Adverse Event

Distinguished Non-Finalist

Presenter Organization OhioHealth Riverside Methodist Hospital Internal Medicine Residency Program

Presenting Author Evan Parsley

Track Adult

Keywords

supplement-induced thyrotoxicosis

hyperthyroidism

thyroidinum

Graves disease

over-the-counter supplements

weight loss supplements

sinus tachycardia

beta-blocker therapy

propylthiouracil

methimazole

Over-the-Counter Supplement

Supplement-Induced Thyrotoxicosis

Thyrotoxicosis

Supplement Use

Adverse Event