Successful Management of a Patient with Pseudomalabsorption of Levothyroxine
Abstract
Pseudomalabsorption of levothyroxine is a factitious disorder. Despite the administration of large doses of levothyroxine, patients with this disorder show hypothyroidism due to noncompliance. These patients are different from the patients with simple noncompliance in that they have a psychiatric disorder. Because their psychological identities are rooted in their being a "patient," they go to great lengths to become and stay a patient. We report a case of pseudomalabsorption of levothyroxine. A 28-year-old woman was referred to us because she was believed to have unusual malabsorption of levothyroxine. We diagnosed the patient as having this factitious disorder, and as treatment, had her visit a hospital twice a week to take medicine under the observation of nurses so that she would not lose her status as a "patient." Her serum free T4 level normalized during three years with twice weekly dosing of thyroxine after hospital discharge. Our approach could be a therapeutic choice for this intractable disorder. To our knowledge, this is the first report of successful management of a patient with pseudomal-absorption of levothyroxine.
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Some patients with mental disorders may lose their insight and refuse to take drugs without informing their medical practitioners.
“It is worth mentioning that some patients with mental disorders may lose their insight and refuse to take drugs without informing their medical practitioners (128, 129).”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [128]
IM or IV injection of LT4 once or twice weekly may also eliminate hypothyroidism due to pseudomalabsorption.
“In addition, IM or IV injection of LT4 once or twice weekly may also eliminate hypothyroidism due to pseudomalabsorption (128, 135, 138).”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [128]
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- Authors
- Kubota, S., Fukata, S., Matsuzuka, F., Kuma, K., & Miyauchi, A.
- Affiliations
- Kuma Hospital (JP)
- Corresponding author
- Kubota, Sumihisa
- Venue
- The International Journal of Psychiatry in Medicine
- Publisher
- SAGE Publications
- Published
- 2003-06
- Volume
- 33
- Issue
- 2
- Pages
- 183-188
- ISSN
- 0033-278X (ISSN-L)
- 0091-2174
- 1541-3527
- OpenAlex
- W2035376611
- Cited by
- 18
- References
- 9
- Citations by year
- 2023: 2 · 2022: 1 · 2020: 1 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 2 · 2012: 1
- FWCI
- 0.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The International Journal of Psychiatry in Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Medical Case Reports and Studies
- Keywords
- factitious disorder, hypothyroidism, medication non-adherence, psychiatric comorbidity
- MeSH terms
- Adult, Diagnosis, Differential, Factitious Disorders, Female, Humans, Hypothyroidism, Malabsorption Syndromes, Thyrotropin, Thyroxine, Treatment Refusal
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