Citation

Groener JB, Lehnhoff D, Piel D, Nawroth PP, Schanz J, Rudofsky G. Am. J. Case Rep. 2013; 14: 48-51.

Copyright

(Copyright © 2013, International Scientific Literature)

DOI

10.12659/AJCR.883788

PMID

unavailable

Abstract

BACKGROUND: Hypothyroidism can usually be treated effectively by oral levothyroxine supplementation. There are, however, some rare circumstances, when oral levothyroxine application is not sufficient, for example malabsorption, interactions with food or other medications, or various gastrointestinal diseases. Case Report: We present a 42 year old woman with refractory and severe symptomatic hypothyroidism after subtotal thyroidectomy in spite of high dose oral levothyroxine supplementation. By stepwise increasing oral levothyroxine dosage up to 2200 micrograms plus 80 micrograms of thyronine, no sufficient substitution could be achieved. After suspicion of enteral malabsorption due to a pathological D-Xylose-test, subcutaneous levothyroxine supplementation was started. Finally, a sustained euthyroid state could be achieved.

CONCLUSIONS: For selected patients who do not respond to oral treatment subcutaneous application of levothyroxine can be a suitable and effective therapy. © Am J Case Rep.

Language: en

Keywords

adult; human; female; case report; depression; suicide attempt; levothyroxine; fatigue; article; cholesterol blood level; cholesterol; thyrotropin; thyrotropin blood level; drug efficacy; weight gain; drug megadose; heart rate; creatine kinase; hypothyroidism; body temperature; blood pressure; liothyronine; hemoglobin A1c; body mass; hair loss; thyroxine; mood change; dry skin; drug dose increase; drug treatment failure; hemoglobin blood level; creatine kinase blood level; weakness; free thyroxine index; Hypothyroidism; Thyroxine; bedtime dosage; body temperature disorder; thyroidectomy; Thyroidectomy; foot edema; malabsorption; hand edema; cold intolerance; free liothyronine index; nodular goiter; Subcutaneous; thyronine; Thyronine; xylose