Valentine Michael J, Kramer Hunter D, Kim James, Pettinelli Nicholas J, Beers Robert J
Family Medicine, Kansas City University, Kansas City, USA.
Family Medicine, Utah Carenow, South Jordan, USA.
Cureus. 2023 Sep 6;15(9):e44787. doi: 10.7759/cureus.44787. eCollection 2023 Sep.
Levothyroxine (LT) is the synthetic form of thyroxine (T4), a thyroid hormone analog used to treat hypothyroidism. LT overdose rarely results in severely poor outcomes. General guidelines for treating exogenous thyrotoxicosis depend on the severity of symptoms. There is no standardized protocol; however, drug discontinuation, beta-blockers (specifically propranolol), and cholestyramine effectively manage overdose when needed, with most cases resolving independently without medical intervention. Here, we present the case of a 26-year-old female with a history of supraventricular tachycardia, anxiety, depression, and Hashimoto thyroiditis who was accidentally overprescribed LT (300 mcg for one and a half months) that resulted in symptoms of lethargy, tremors, body temperature dysregulation, orthostatic hypotension, and diarrhea. This case, with limited evidence, suggests that excessive LT exacerbated the patient's underlying psychiatric symptoms, encouraging suicidal ideation.
左甲状腺素（LT）是甲状腺素（T4）的合成形式，是一种用于治疗甲状腺功能减退症的甲状腺激素类似物。LT过量很少导致严重不良后果。治疗外源性甲状腺毒症的一般指南取决于症状的严重程度。没有标准化方案；然而，停药、β受体阻滞剂（特别是普萘洛尔）和考来烯胺在需要时可有效处理过量情况，大多数病例无需医疗干预即可自行缓解。在此，我们报告一例26岁女性病例，该患者有室上性心动过速、焦虑、抑郁和桥本甲状腺炎病史，意外超量开具LT（300微克，持续一个半月），导致出现嗜睡、震颤、体温调节异常、体位性低血压和腹泻症状。该病例证据有限，提示过量的LT加剧了患者潜在的精神症状，引发了自杀念头。
