Thyroid Hormone Use in Individuals With Eating Disorders

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.