Consumptive Hypothyroidism

This episode examines consumptive hypothyroidism, a rare paraneoplastic syndrome driven by the accelerated degradation of thyroid hormones. We discuss how vascular and mesenchymal tumors, such as infantile hepatic hemangiomas and gastrointestinal stromal tumors, aberrantly overexpress the inactivating enzyme type three iodothyronine deiodinase. The discussion covers the classic biochemical profile of elevated thyroid stimulating hormone and markedly increased reverse triiodothyronine, alongside the aggressive, high-dose hormone replacement strategies and tumor-targeted interventions required to successfully restore systemic euthyroidism.