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On June 18, 2015, a woman aged 30 years was brought to the Staten Island University Hospital Emergency Department (ED) in New York by her mother, who reported that the patient had become acutely confused at home, was repeating herself, and did not recognize her family members. She had a diagnosis of bipolar disorder for which she took lithium, and she had a history notable for polysubstance abuse (use of three or more addictive drugs in the past 12 months). Her other medications included risperidone (an antipsychotic), benztropine (an anticholinergic), and bupropion (an antidepressant). ED staff members learned from the patient's mother that the patient had started taking "diet pills" that contained a thyroid hormone, which the patient had purchased through the Internet 2 weeks earlier. The patient volunteered that she had doubled the dosage 1 week earlier, in an attempt to lose more weight.

Notes from the Field: Thyrotoxicosis After Consumption of Dietary Supplements Purchased Through the Internet — Staten Island, New York, 2015