Levothyroxine Abuse and Bulimia Nervosa

Bulimia nervosa is a fairly common disorder primarily affecting adolescent and young adult women. The illness is characterized by recurrent eating binges with compensatory behaviors in an attempt to prevent weight gain. The classic compensatory behavior is self-induced vomiting, but the use of diet pills, diuretics and laxatives, extreme fasting, and compulsive exercise have been described. We report a case of hyperthyroidism induced by self-administration of excessive levothyroxine in a woman with bulimia nervosa.