Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Dec 13;11(1):e227946.
doi: 10.1136/bcr-2018-227946.

Thyroxine-induced periodic paralysis: a rare complication of nutritional supplements

Affiliations
Case Reports

Thyroxine-induced periodic paralysis: a rare complication of nutritional supplements

Muhammad Arslan Cheema et al. BMJ Case Rep. .

Abstract

The consumption of daily nutritional supplements has risen dramatically all over the world. Many people believe that dietary supplements, if not useful, are at least safe to fulfil small dietary gaps. Many nutritional supplements have not been approved by Federal Drug Administration due to their unregulated active ingredients, but they are available as over the counter. One of the active ingredients, exogenous triiodothyronine (T3), has been reported in dietary supplements. We present a case of sudden onset of tetraparesis. Laboratory workup showed hypokalaemia, low thyroid-stimulating hormone and thyroxine (T4) but normal T3 and thyroglobulin levels. The radioiodine uptake scan also showed reduced uptake. After aggressive serum potassium correction and stopping supplements, his condition got improved. So the suspicion of exogenous T3-induced thyrotoxic periodic paralysis was confirmed.

Keywords: hyperthyroidism; metabolic disorders; neuroendocrinology; unwanted effects / adverse reactions; vitamins and supplements.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

References

    1. Kung AW. Clinical review: Thyrotoxic periodic paralysis: a diagnostic challenge. J Clin Endocrinol Metab 2006;91:2490–5. 10.1210/jc.2006-0356 - DOI - PubMed
    1. Sinharay R. Hypokalaemic thyrotoxic periodic paralysis in an Asian man in the United Kingdom. Emerg Med J 2004;21:120–1. 10.1136/emj.2003.006684 - DOI - PMC - PubMed
    1. Chou HK, Tsao YT, Lin SH. An unusual cause of thyrotoxic periodic paralysis: triiodothyronine-containing weight reducing agents. Am J Med Sci 2009;337:71–3. 10.1097/01.MAJ.0000310783.66897.b6 - DOI - PubMed
    1. Akinyemi E, Bercovici S, Niranjan S, et al. . Thyrotoxic hypokalemic periodic paralysis due to dietary weight-loss supplement. Am J Ther 2011;18:e81–e83. 10.1097/MJT.0b013e3181c960a9 - DOI - PubMed
    1. Panikkath R, Nugent K. I lost weight, but I became weak and cannot walk-a case of nutraceutical (T3)-induced thyrotoxic periodic paralysis. Am J Ther 2014;21:e211–e214. 10.1097/MJT.0b013e318288a460 - DOI - PubMed

Publication types