SUN-575 Anabolic Steroids Induced Hyperthyroidism

Anabolic steroid injections widely used by athletes during strength training period, all studies were done in this field showed transient effect of androgenic anabolic steroids on thyroid which were mainly causing hypothyroidism, However hyperthyroidism cases were never reported up to our knowledge. We present a 25-year-old Emarati male previously healthy, who is referred to endocrine service for hyperthyroidism management. He presented with thyrotoxicosis manifestations. Medical history revealed that he was using anabolic steroids, testosterone, and gonadotropin injection which were prescribed in private gym by trainer. Anabolic steroids were taken twice for few months over 2years prior to his current presentation with hyperthyroidism. Autoimmune profile was negative for thyroid disorder. Radioiodine uptake scan was normal initially then after a year showed diffuse uptake. No evidence of clear cause of his hyperthyroidism. He remained in thyrotoxic state for more than a year post stopping the anabolic steroids. He was treated with radioactive iodine ablation (RAI) according to his preference. Develop post-RAI thyroiditis treated with beta blockers and analgesia. Symptoms completely resolved after 6 weeks and thyroid function returned to normal. The patient has remained asymptomatic on continued follow up care. This case points to the effect of anabolic steroids on thyroid function. Hence all published studies showed that it could cause hypothyroidism not hyperthyroidism. few Literatures are showing that anabolic steroid’s prominent effect on human thyroid function is reduction of TBG with consequent reduction of Total T3 and T4. In rats, anabolic steroids also act in the peripheral metabolism of thyroid hormones and seem to exert an important proliferative effect on thyroid cells. By this effect we believe that, anabolic steroid might cause hyperthyroidism in our patient. To our knowledge, this is the first case report addressing anabolic steroids causing permanent hyperthyroidism. Our patient proved that the effect of anabolic steroid was not transient as he remained in thyrotoxic state for more than a year after stopping steroids and uptake scan showed diffuse high uptake which goes with thyroid cells proliferation hypothesis.