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Hypothyroidism due to Hashimoto's thyroiditis masked by anorexia nervosa
Author(s) -
SmallsMantey Adjoa,
Steinglass Joanna,
Primack Marshall,
ClarkHamilton Jill,
Bongiovi Mary
Publication year - 2015
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.22420
Subject(s) - thyroiditis , anorexia nervosa , medicine , thyroid function , endocrinology , weight loss , anti thyroid autoantibodies , thyroid function tests , weight gain , anorexia , thyroid , body weight , eating disorders , immunology , obesity , antibody , psychiatry , autoantibody
ABSTRACT Anorexia nervosa (AN) is typically associated with altered thyroid function tests, notably a low total and free T 3 , and lower, but within normal range, free T 4 and TSH. A 16‐year‐old girl with a four‐year history of AN presented with elevated TSH that fluctuated with changes in weight. TSH was within normal limits (1.7–3.64 mIU/L) following periods of weight loss and elevated with weight gain (5.9–21.66 mIU/L). Antithyroperoxidase antibodies were markedly elevated, suggesting chronic Hashimoto's thyroiditis. Of note, the elevated TSH that would be expected in Hashimoto's thyroiditis was blunted by weight loss associated with AN. Physicians should be aware that AN may contribute to masking thyroid abnormalities in Hashimoto's thyroiditis. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:932–935).