RICHARD P. LEVY, M.D.
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To the editor: Rose, Sanders, Webb, and Hines (Ann Intern Med 71:309, 1969) correctly call attention to factitial ingestion of thyroid hormone as a cause of hyperthyroidism. Although all three patients whom they describe denied taking any thyroid hormone, there seems to be little question that Patients 2 and 3 were doing so. The diagnosis in Patient 1 is open to some doubt, and the data presented can be interpreted differently than was done by the authors.
First, both the 3-hr and 24-hr thyroid 131I uptakes can be considered normal, especially in this era of iodine-rich bread (1, 2). Second,
LEVY RP. Occult Thyrotoxicosis. Ann Intern Med. 1970;72:286. doi: 10.7326/0003-4819-72-2-286
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Published: Ann Intern Med. 1970;72(2):286.
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