Antibiotics play an important role for the treatment and prevention of invasive
Haemophilus influenzae
disease. Antimicrobial resistance survey of invasive
H. influenzae
isolates collected in 2016 showed that the US
H. influenzae
population remained susceptible to clinically relevant antibiotics, except for ampicillin.
What is known and objective
Over the counter supplements are often taken for granted during medication reconciliation in the emergency department. Supplements are not regulated by FDA, and some can be potentially dangerous.
Case summary
We report a case of thyrotoxicosis secondary to over the counter bovine thyroid supplements. Our patient presented with atrial fibrillation with rapid ventricular response refractory to calcium channel blockers. Had we not known about the supplement, the course of treatment would have been different with potential adverse outcome.
What is new and conclusion
Natural thyroid supplements are marketed as over the counter products and are largely unregulated. Thyroid extracts have been found to have disparaging inconsistencies in composition, delivering anywhere from non‐existent to supratherapeutic doses. Thyroid supplements should be regulated considering the potential side effects.
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