Naturopathic tonic leads to toxicosis

By Dr Mona Botros, chemical pathology registrar

A MALE patient, aged 47, presents with weight loss, hand tremor, tachycardia of 105 beats per minute and insomnia. 

Blood pressure is normal and the thyroid gland is normal to palpation. You order thyroid function tests to rule out hyperthyroidism.

The results show a low thyroid stimulating hormone of 0.2 (0.5–5mIU/L) and a low normal FT4 of 10 (10–20pmol/L). 

You ring the pathologist and agree that a FT3 should be added.

This comes back at 11 (4.5–8.0pmol/L).