Introduction:
To restore normal thyroid hormone levels in hypothyroidism, oral
levothyroxine sodium (LT4) continues to be the cornerstone of treatment.
Levothyroxine absorption can be affected by age, patient compliance,
fasting, and the consumption of certain foods or medications (1)(2).
Refractory hypothyroidism can have numerous causes, including poor or
non-adherence to levothyroxine daily doses, deiodinase deficiency, and
various malabsorption disorders. Here we present a case of a 27-year-old
female patient with refractory hypothyroidism with no response to oral
levothyroxine that was managed with intravenous (IV) levothyroxine.