title: Hypothyroidism due to Hashimoto's thyroiditis masked by anorexia nervosa.
abstract: Anorexia nervosa (AN) is typically associated with altered thyroid function tests, notably a low total and free T3 , and lower, but within normal range, free T4 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.
authors.affiliation: College of Physicians and Surgeons, Columbia University Medical Center, New York.
authors.forename: Adjoa
authors.initials: A
authors.lastname: Smalls-Mantey
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute, New York.|Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Joanna
authors.initials: J
authors.lastname: Steinglass
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute, New York.
authors.forename: Marshall
authors.initials: M
authors.lastname: Primack
authors.affiliation: Adolescent/Young Adult Center for Health, Goryeb Children's Hospital, Morristown, New Jersey.
authors.forename: Jill
authors.initials: J
authors.lastname: Clark-Hamilton
authors.affiliation: College of Physicians and Surgeons, Columbia University Medical Center, New York.|Department of Psychiatry, New York State Psychiatric Institute, New York.
authors.forename: Mary
authors.initials: M
authors.lastname: Bongiovi
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000150:complications*; D005260:Female; D050031:Hashimoto Disease / Q000150:complications*; D006801:Humans; D007037:Hypothyroidism / Q000209:etiology*; D013974:Thyroxine
chemical_list: D013974:Thyroxine
keywords: Hashimoto's thyroiditis; TSH; anorexia nervosa; hypothyroidism