Introduction:
Thyrotoxicosis factitia is most often caused by excessive ingestion of thyroid hormones which could be intentional or inadvertent (contamination of dietary supplements). Possible causes of hyperthyroidism are Graves disease, toxic thyroid adenoma, multinodular goiter, some forms of subacute or chronic thyroiditis and rare pituitary thyroid-stimulating hormone (TSH) producing tumors, other causes can be extra thyroid in origin, may occur in ovaric strumma and thyrotoxicosis factitia, due to intentional or accidental excessive intake of pharmaceutical thyroid hormone preparations or thyroxin-contaminated ground beef [1].
The possibility of thyrotoxicosis factitia should be considered in patients who have features of hyperthyroidism and psychiatric disturbance without any evidence of goitre or proptosis and the results of thyroid function are conflicting [2].
This case report draws attention to one such instance wherein there was an apparent thyrotoxicosis due to secretive ingestion of levothyroxine [2]. Our patient attended to outpatient clinic during the last five year period with clinical features suggestive of hyperthyroidism, and a combination of thyroid function tests indicating that she was taking exogenous thyroxine.