North Shore Long Island Jewish Health System, Lake Success, New York.
Endocr Pract. 2011 Jul-Aug;17(4):610-5. doi: 10.4158/EP10137.RA.
To review the potential adverse effects of thyroid hormone-based nutraceuticals and describe a case of thyrotoxic periodic paralysis (TPP) after abuse of a dietary supplement containing 3,5,3'-triiodothyroacetic acid (tiratricol).
We review the literature on potential dangers and therapeutic misadventures of thyroid hormone-based nutraceuticals and present the clinical, laboratory, and radiologic data of a bodybuilder in whom hypokalemic TPP developed after use of "Triax Metabolic Accelerator".
A 23-year-old white man developed lower extremity paralysis, diaphoresis, and palpitations in the setting of low serum potassium levels. Laboratory results showed suppressed thyroid-stimulating hormone, low levels of free and total thyroxine, low total triiodothyronine level, and very low 24-hour radioiodine uptake. The patient ultimately admitted to taking a supplement containing tiratricol for approximately 2 months, and hypokalemic TPP was diagnosed. He was treated with potassium supplementation and a β-adrenergic blocking agent, which completely resolved his symptoms. Results of thyroid function tests normalized or approached normal 1 week after hospitalization, and future use of dietary supplements was strongly discouraged. Despite 2 warnings by the US Food and Drug Administration, products containing tiratricol are still available for sale on the Internet.
This report illustrates both an unusual adverse effect of a nutraceutical containing tiratricol and the importance of educating our patients about the risks versus benefits of using these widely available but loosely regulated products.
综述甲状腺激素类营养保健品的潜在不良反应，并描述 1 例滥用含有 3,5,3'-三碘甲状腺原氨酸（Tiratricol）的膳食补充剂后出现甲状腺毒症周期性瘫痪（TPP）的病例。
我们回顾了关于甲状腺激素类营养保健品潜在危险和治疗失误的文献，并介绍了 1 例健美运动员的临床、实验室和影像学数据，他在使用“Triax 代谢加速剂”后出现低钾性 TPP。
1 名 23 岁白人男子在血清钾水平低的情况下出现下肢瘫痪、出汗和心悸。实验室结果显示促甲状腺激素抑制、游离和总甲状腺素水平低、总三碘甲状腺原氨酸水平低、24 小时放射性碘摄取非常低。患者最终承认服用了含有 Tiratricol 的补充剂约 2 个月，诊断为低钾性 TPP。他接受了钾补充和β肾上腺素能阻滞剂治疗，症状完全缓解。住院后 1 周，甲状腺功能检查结果正常或接近正常，强烈劝阻患者日后使用膳食补充剂。尽管美国食品和药物管理局发出了 2 次警告，但含有 Tiratricol 的产品仍在互联网上销售。
本报告说明了含有 Tiratricol 的营养保健品的一种不常见的不良反应，以及教育我们的患者了解使用这些广泛可用但监管宽松的产品的风险与收益的重要性。
