title: Over-the-counter-drug-induced thyroid disorders.
abstract: OBJECTIVE
  Excessive iodine ingestion may cause thyroid dysfunction. In this case series, we report four patients who developed significant thyroid dysfunction after ingesting over-the-counter (OTC) drugs containing large concentrations of iodine.
  
  
  METHODS
  Four patients from a tertiary medical center are reported.
  
  
  RESULTS
  Case 1 involved acute exacerbation of thyrotoxicosis induced by taking OTC Tri-iodine™ in a 35-year-old woman while still on methimazole therapy. Case 2 involved thyroid-extract-induced thyrotoxicosis following ingestion of Thyromine™, and was confirmed by laboratory studies and ¹³¹I thyroid uptake. Cases 3 and 4 involved severe, symptomatic hypothyroidism induced in 2 patients with underlying autoimmune thyroiditis (Hashimoto's disease) following ingestion of Iodoral™. In all cases, thyroid dysfunction resolved with appropriate management and discontinuation of the OTC drugs.
  
  
  CONCLUSIONS
  These case reports demonstrate the significant risks associated with OTC preparations containing iodine in patients predisposed to thyroid dysfunction. There is no valid reason for taking high-dose OTC iodine supplements, which have been shown to cause harm and have no known benefit.
authors.affiliation: Department of Endocrinology, Walter Reed National Military Medical Center, Bethesda, MD 20889-5600, USA.
authors.forename: Thanh D
authors.initials: TD
authors.lastname: Hoang
authors.forename: Vinh Q
authors.initials: VQ
authors.lastname: Mai
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Clyde
authors.forename: Mohamed K M
authors.initials: MK
authors.lastname: Shakir
mesh_terms: D000328:Adult; D019587:Dietary Supplements / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D007455:Iodine / Q000097:blood / Q000506:poisoning*; D008396:Maryland; D008875:Middle Aged; D011193:Potassium Iodide / Q000009:adverse effects; D013962:Thyroid (USP) / Q000009:adverse effects; D013959:Thyroid Diseases / Q000097:blood / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D013961:Thyroid Gland / Q000503:physiopathology*; D013971:Thyrotoxicosis / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D013962:Thyroid (USP); D011193:Potassium Iodide; D007455:Iodine