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In 2008, Poon et al reported 3 patients found with factitious thyrotoxicosis secondary to herbal supplements for weight loss (40).
Factitious thyrotoxicosis and herbal dietary supplement for weight reduction.
In the differential diagnosis of recurrent thyrotoxicosis apart from silent thyroiditis, Hashimoto's thyroiditis, subacute thyroiditis, postpartum thyroiditis (1,4), and factitious thyrotoxicosis should be included.
Recurrence of thyrotoxicosis and the profession of the patient brings to mind factitious thyrotoxicosis which will also cause low uptake on thyroid scan, but in these cases, thyroglobulin levels will either be low or undetectable (10).