Karkowski Katie, Carroll James L
University of Rhode Island, Kingston, RI, USA.
The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
J Pharm Technol. 2014 Jun;30(3):102-105. doi: 10.1177/8755122514529414. Epub 2014 Mar 24.
: We report the case of a patient who presented to the hospital in thyroid storm following the use of several iodine-containing dietary supplements (DS) and homeopathic remedies (HR). : The patient was a 76-year-old woman with no personal or family history of thyroid or autoimmune disease. On laboratory assessment, a thyroid panel showed that her total T3 and T4 were elevated at 334 ng/dL and 14.6 µg/dL, respectively; thyroid stimulating hormone was undetectable; and thyroid stimulating immunoglobulin was positive at 7.4. The patient had been consuming 170 µg of iodine daily for the past 2 months via her DS and HR. An objective causality assessment using the Naranjo adverse drug reaction probability scale revealed that an adverse effect was probable. The patient likely suffered from iodine-induced thyrotoxicosis secondary to the consumption of numerous DS and HR. : Dietary supplements and homeopathic remedies can pose significant health risks. The safety of these products is not assured as they are incompletely monitored by the Food and Drug Administration. Individuals who take these compounds do so at their own risk and should pay close attention to product contents. : The labeling of DS and HR products may be misleading. Pharmacists and clinicians are advised to inquire about the use of DS and HR products. When use is identified, the products should be subject to a thorough review.
我们报告了一例患者,该患者在使用多种含碘膳食补充剂(DS)和顺势疗法药物(HR)后因甲状腺危象入院。该患者为一名76岁女性,无甲状腺或自身免疫性疾病的个人或家族病史。实验室评估显示,甲状腺功能检查结果为总T3和T4分别升高至334 ng/dL和14.6 μg/dL;促甲状腺激素检测不到;促甲状腺素受体抗体为阳性,数值为7.4。在过去两个月里,该患者通过其服用的DS和HR每日摄入170 μg碘。使用Naranjo药物不良反应概率量表进行的客观因果关系评估显示,很可能存在不良反应。该患者可能因大量服用DS和HR继发碘致甲状腺毒症。膳食补充剂和顺势疗法药物可能会带来重大健康风险。由于食品药品监督管理局对这些产品的监管不全面,其安全性无法得到保证。服用这些化合物的个人需自行承担风险,应密切关注产品成分。DS和HR产品的标签可能具有误导性。建议药剂师和临床医生询问患者是否使用DS和HR产品。一旦确认使用,应对这些产品进行全面审查。