Most patients with hypothyroidism respond to administration of oral thyroxine at a maintenance dose of 50–175 μg/day. This is the first documented patient with post-operative hypothyroidism who required about 10 times the standard dose of thyroxine, and whose symptoms only resolved when intravenous thyroxine was administered daily. Our findings support the benefits of daily intravenous therapy with thyroxine in this case.
YamamotoMYoshidaKYonezawaKMizugakiM: Parenteral replacement of L-T4 in hypothyroid patients with esophageal stenosis and unconsciousness (in Japanese, English abstract). Nippon Naibunpi Gakkai Zasshi1993; 69: 588–593
2.
RidgwayECMcCammonJABenottiJMaloofF: Acute metabolic responses in myxedema to large doses of intravenous L-thyroxine. Ann Intern Med1972; 77: 549–555
3.
MaedaMKuzuyaNMatuyamaYImaiYIkedaH: Changes in serum triiodothyronine, thyroxine, and thyrotropin during treatment with thyroxine in severe hypothyroidism. J Clin Endocrinol Metab1976; 43: 10–17
4.
BrentGALarsenP Reed: Treatment of hypothyroidism. In: Werner and Ingbar's The Thyroid, 7th edn (BravermanLEUtigerRD, eds). Philadelphia: Lippincott-Raven Publishers, 1996; pp883–887
5.
ArlotSDebusscheXLalauJDMesmacqueATolaniMQuichaudJ: Myxoedema coma: response of thyroid hormones with oral and intravenous high-dose L-thyroxine treatment. Intensive Care Med1991; 17: 16–18
6.
ShermanSITielensETLadensonPW: Sucralfate causes malabsorption of L-thyroxine. Am J Med1994; 96: 531–535
7.
NorthcuttRCStielJNHollifieldJWStantEGJr: The influence of cholestyramine on thyroxine absorption. JAMA1969; 208: 1857–1861
8.
SuzukiYTakeshitaEKanoSHirataSSitoS: Impaired intestinal absorption of thyroid hormone in a case of Hashimoto's disease with anti-T3 and anti-T4 antibody (in Japanese, English abstract). Nippon Naibunpi Gakkai Zasshi1982; 58: 1487–1497
9.
BatalisTMuersMRoyleGT: Treatment with intravenous triiodothyronine of colonic pseudo-obstruction caused by myxoedema. Br J Surg1981; 68: 439
10.
MiyauchiAKataokaKSuzukiYKishiHTakaiSOkagawaK: Parenteral replacement of thyroid hormone antibody (in Japanese, English abstract). Nippon Naibunpi Gakkai Zasshi1984; 60: 23–29
