A 29-year-old Bodybuilder with Liothyronine-induced Thyrotoxic Hypokalaemic Periodic Paralysis

  • Querijn van Bokhorst Department of Internal Medicine, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
  • Yvonne Krul-Poel Department of Internal Medicine, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
  • Diederik Smit Department of Internal Medicine, Elisabeth-TweeSteden Ziekenhuis, Tilburg, The Netherlands
  • Willem de Ronde Department of Internal Medicine, Spaarne Gasthuis, Haarlem, The Netherlands

Keywords

Thyrotoxicosis, hypokalemic periodic paralysis, liothyronine, androgens

Abstract

We describe a 29-year-old male bodybuilder with recurrent attacks of myalgia and muscle weakness associated with hypokalaemia and thyrotoxicosis due to abuse of liothyronine. The attacks quickly resolved after potassium supplementation and liothyronine cessation. We concluded that the patient had thyrotoxic hypokalaemic periodic paralysis (TPP). Although muscle weakness and hypokalaemia are prominent symptoms of TPP, underlying thyrotoxicosis may be overlooked. Up to 25% of androgen abusers also abuse thyroid hormone. Lack of recognition of thyroid hormone abuse as a cause of hypokalaemic periodic paralysis may result in unnecessary, potentially harmful medical investigations and improper treatment and advice.

 

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References

  • Kung A. Thyrotoxic periodic paralysis: a diagnostic challenge. J Clin Endocrinol Metab 2006;91(7):2490–2495.
  • Maciel R, Lindsey S, Dias da Silva M. Novel etiopathophysiological aspects of thyrotoxic periodic paralysis. Nat Rev Endocrinol 2011;7(11):657–667.
  • Ryan D, Dias da Silva M, Soong T, Fontaine B, Donaldson M, Kung A et al. Mutations in potassium channel Kir2.6 cause susceptibility to thyrotoxic hypokalemic periodic paralysis. Cell 2010;140(1):88–98.
  • Smit D, Hon O, Venhuis B, den Heijer M, Ronde W. Baseline characteristics of the HAARLEM study: 100 male amateur athletes using anabolic androgenic steroids. Scand J Med Sci Sports 2019;30(3):531–539.
  • Smit D, de Ronde W. Outpatient clinic for users of anabolic androgenic steroids: an overview. Neth J Med 2018;76(4):167.
  • Published: 2021-03-04

    Issue: Vol 8 No 3 (view)

    Section: Articles

    How to cite:
    1.
    van Bokhorst Q, Krul-Poel Y, Smit D, de Ronde W. A 29-year-old Bodybuilder with Liothyronine-induced Thyrotoxic Hypokalaemic Periodic Paralysis. EJCRIM 2021;8 doi:10.12890/2021_002362.