FACTITIOUS hyperthyroidism is higher than normal thyroid hormone levels that occur from taking too much thyroid hormone medication. Alternative names for the disease are factitious thyrotoxicosis, thyrotoxicosis factitia, thyrotoxicosis medicamentosa.
Known causes
The thyroid gland produces the hormones thyroxine (T4) and triiodothyronine (T3). In most cases of hyperthyroidism, the thyroid gland itself produces too much of these hormones.
However, hyperthyroidism can also be caused by taking too much thyroid hormone medication for hypothyroidism.
This is called factitious hyperthyroidism.
When this occurs because the prescribed dose of hormone medication is too high, it is called iatrogenic, or “doctor-induced,” hyperthyroidism.
Factitious hyperthyroidism can also occur when a patient intentionally takes too much thyroid hormone, such as in people who have psychiatric disorders such as Munchausen syndrome, who are trying to lose weight pr who want to get compensation from the insurance company. In rare cases, factitious hyperthyroidism is caused by eating meat contaminated with thyroid gland tissue.
Identify it
The symptoms of factitious hyperthyroidism are the same as those of hyperthyroidism caused by the thyroid gland, with these exceptions -- there is no goiter.
The thyroid gland is usually small, the eyes do not bulge, as they do in Graves disease (the most common type of hyperthyroidism), the skin over the shins does not thicken, as it occasionally does with people who have Graves disease.
When factitious hyperthyroidism lasts a long time, patients are at risk for the same complications of untreated or improperly treated hyperthyroidism caused by the thyroid gland.
These complications include atrial fibrillation, chest pain (angina), heart attack, irregular heart rhythm, loss of bone mass (if severe, osteoporosis), weight loss.
Prevention
Thyroid hormone should be taken only by prescription and under the supervision of a licensed physician.
Treatment
You must stop taking thyroid hormone.
If it is medically necessary, the dose must be reduced. You should be re-evaluated in two to four weeks to be sure that the signs and symptoms of hyperthyroidism are gone.
This also helps to confirm the diagnosis.
People with Munchausen syndrome will need psychiatric treatment and follow-up.
Factitious hyperthyroidism will clear up on its own when you stop taking or lower the dose of thyroid hormone.
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