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.