Thyroid Hormone Use in Individuals With Eating Disorders

European Eating Disorders Review
By Dennis Gibson, MD, FACP, CEDS Marina Foster, BA

Abstract

Objective

Individuals with eating disorders are at an increased risk for misuse of thyroid hormone for several reasons, including the overlap in many of the clinical symptoms between malnutrition and hypothyroidism, changes to the hypothalamic-pituitary-thyroid axis, and increased frequency of compensatory behaviours. The purpose of this descriptive study is to investigate thyroid hormone use in individuals with eating disorders and its impact on thyroid function tests.

Method

In this retrospective, descriptive study, chart review was used to investigate thyroid hormone use for 341 individuals seeking medical stabilisation for their eating disorders.

Results

10.6% of the cohort were taking various formulations of thyroid hormone replacement. Use of thyroid hormone was associated with greater frequency of low serum thyroid stimulating hormone (TSH) and abnormal free thyroxine.

Conclusions

Frequency of thyroid hormone use in this cohort is significantly greater than would be expected compared to the prevalence of thyroid disease from epidemiologic studies. The greater likelihood of low serum TSH in those taking thyroid hormones also suggests an increased risk for use of excessive hormone doses. Therefore, eating disorder providers must gather additional information upon learning that eating disorder clients are using thyroid hormones, as these occasions may offer an important opportunity for treatment intervention.

Highlights

  • Individuals with eating disorders were taking thyroid hormones at a much greater frequency than would be expected based on the prevalence of thyroid disease.

  • Increased likelihood of low thyroid stimulating hormone in individuals taking thyroid hormones compared to individuals not taking thyroid hormone suggests an increased risk for use of excessive doses of thyroid hormone.

  • Use of thyroid hormone in those with eating disorders should serve as an important opportunity for additional information gathering, in order to better understand the rationale for its use and potentially serve as an opportunity for treatment intervention.

DOI:
https://doi.org/10.1002/erv.70129
Written by
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Dennis Gibson, MD, FACP, CEDS

Dennis Gibson, MD, FACP, CEDS serves as a consulting physician for ACUTE. Dr. Gibson joined ACUTE in 2017 and has since dedicated his clinical efforts to the life-saving medical care of patients with…
Written by
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Marina Foster, BA

Marina Foster, BA, serves as the Research Project Coordinator at the ACUTE Center for Eating Disorders and Severe Malnutrition. She has been with ACUTE since 2018, initially joining as an Operations…

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