Massive Levothyroxine Ingestion: Conservative Management

Scott H. Mandel, A. Roy Magnusson, Brent T. Burton, J. Robert Swanson, Stephen H. Lafranchi

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


The clinical course of a 29-month-old girl who was referred for evaluation after ingesting ninety 0.2-mg tablets of levothyroxine is reported. Despite an initial thyroxine (T4) level of 282 μg/dl and a triiodothyronine (T3) level of 1,837 ng/dl at 48 hours postingestion, her symptoms were mild and included irritability, vomiting, tremor, and tachycardia. Treatment was limited to activated charcoal and propranolol. Thyroid hormone levels fell to normal by 13 days postingestion. The child's clinical course was benign. Even after massive acute ingestions of levothyroxine, children's symptoms are usually mild and may be controlled with propranolol. This conservative approach should be considered before expensive and potentially dangerous therapies are undertaken.

Original languageEnglish (US)
Pages (from-to)374-376
Number of pages3
JournalClinical pediatrics
Issue number8
StatePublished - Aug 1989
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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