Abstract:
This case report details the clinical scenario of a 27-year-old female
patient diagnosed with idiopathic refractory hypothyroidism. Despite
adherence to prescribed oral levothyroxine therapy, she continued to
experience persistent symptoms such as fatigue and cold intolerance. The
exploration of her condition delved into the complexities of refractory
hypothyroidism, encompassing both its diagnostic challenges and
therapeutic management. A critical distinction was made between true
levothyroxine malabsorption and pseudo-malabsorption, the latter being
attributed to issues with medication adherence. The scarcity of research
on intravenous levothyroxine use in such cases was noted, highlighting
the novelty of this approach. The patient’s favorable response to
intravenous levothyroxine administration, marked by complete symptom
resolution and sustained euthyroid state over four years, provides
valuable insights. This case contributes significantly to the existing
knowledge on the idiopathic etiologies of refractory hypothyroidism and
advocates for the consideration of intravenous levothyroxine as an
effective alternative when oral administration proves inadequate.