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Thyrotoxicosis factitia (alimentary thyrotoxicosis, exogenous thyrotoxicosis) [1] [2] is a condition of thyrotoxicosis caused by the ingestion [3] of exogenous thyroid hormone. [4] [5] It can be the result of mistaken ingestion of excess drugs, such as levothyroxine [6] and triiodothyronine, [7] or as a symptom of Munchausen syndrome.
The main strategies for the management of thyroid storm are reducing production and release of thyroid hormone, reducing the effects of thyroid hormone on tissues, replacing fluid losses, and controlling temperature. [5] Thyroid storm requires prompt treatment and hospitalization. Often, admission to the intensive care unit is needed. [21]
Once the thyroid function is reduced, replacement hormone therapy (levothyroxine) taken orally each day replaces the thyroid hormone that is normally produced by the body. [ 46 ] There is extensive experience, over many years, of the use of radioiodine in the treatment of thyroid overactivity and this experience does not indicate any increased ...
The effects of excess thyroid hormone typically respond to the administration of a non-selective beta blocker, such as propranolol (as most of the symptoms are driven by increased levels of adrenaline and its effect on the β-adrenergic receptors). Subsequent attacks may be prevented by avoiding known precipitants, such as high salt or ...
Administering the radioactive isotope causes the thyroid to take in the lethal iodine and quickly radiation destroys it. [12] Typically overproduction of thyroxine using radio-iodine is blocked with one dose. The drawback to this treatment is the thyroid gland is completely destroyed and patients often develop hypothyroidism. Some do so only a ...
Amiodarone has both direct and indirect effects on thyroid function. The most notable indirect thyroid altering property is that the drug is approximately one-third iodine by weight. As a result, amiodarone therapy elevates free circulating iodine levels up to 40 times greater than the iodine intake from the average American diet. [2]
However, deprescribing may be considered if a patient experiences side effects like rapid heart rate, anxiety, or bone loss, or if their thyroid function tests normalize.”
Adoption of ICD-10-CM was slow in the United States. Since 1979, the US had required ICD-9-CM codes [11] for Medicare and Medicaid claims, and most of the rest of the American medical industry followed suit. On 1 January 1999 the ICD-10 (without clinical extensions) was adopted for reporting mortality, but ICD-9-CM was still used for morbidity ...