A Case of Hyperthyroidism in a Patient Using the Nutritional Supplement “Survival Shield”

ABSTRACT Objective: Many patients take dietary supplements, which are unregulated. Some of these may contain iodine. Labeling regarding iodine content may be inaccurate, and potential side effects are not explained. Methods: We present the case of a healthy 39-year-old man who presented with 10-pound weight loss. He reported taking a dietary supplement, “Survival Shield,” which contained 1,300% of the recommended dietary allowance of iodine. Labs demonstrated thyroid-stimulating hormone level of <0.03 IU/mL (normal, 0.27 to 4.2 IU/mL), free thyroxine 2.88 ng/dL (normal, 0.9 to 1.8 ng/dL), and total triiodothyronine 194 ng/dL (normal, 76 to 181 ng/dL), consistent with hyperthyroidism. Additionally, the patient was found to have elevated levels of anti–thyroid peroxidase antibodies at 59.7 IU/mL (normal, 0 to 35 IU/mL). Hyperthyroidism gradually resolved with cessation of supplements, and anti–thyroid peroxidase antibody titers returned to normal. Results: This patient developed hyperthyroidism due to iodine excess from taking a nutritional supplement. His laboratory measurements returned to normal upon cessation of iodine supplementation. He also regained 4 pounds. Conclusion: The case adds to the limited data available regarding previously euthyroid patients developing iodine-induced hyperthyroidism due to nutritional supplements in iodine-sufficient areas. Abbreviation: TSH = thyroid-stimulating hormone