Evidence map›Paper›PMID 31937628›Full record

ArticleBMJ case reports2020

Delayed diagnosis of T3 supplementation in a bodybuilder presenting with tachycardia and features of sepsis.

Bronwen E Warner, Charles J Woodrow, Aparna Pal

Open access · greenAbstract readCase Reports
In one paragraph

Article in BMJ case reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Poisoning with Thyroid Hormones Used Illegally-Systematic Review.Pharmaceuticals (Basel, Switzerland) · 2025
    Review
  4. Review
  5. Article
  6. Thyroid Hormone Abuse in Elite Sports: The Regulatory Challenge.The Journal of clinical endocrinology and metabolism · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Bronwen E WarnerInternal Medicine, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0003-1897-4682
Charles J WoodrowNuffield Department of Clinical Medicine, Oxford, Oxfordshire, UK.ORCID http://orcid.org/0000-0002-5134-7165
Aparna PalRadcliffe Department of Medicine, Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford, Oxfordshire, UK Aparna.Pal@ouh.nhs.uk.ORCID http://orcid.org/0000-0002-5854-8920
Imperial College Healthcare NHS Trust · GBOxford Centre for Diabetes, Endocrinology and Metabolism · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A 25-year-old man presented generally unwell to the emergency department. Initial assessment identified systemic inflammatory response syndrome markers with an insect bite as a potential source of infection and he was treated for presumed sepsis. Tachycardia persisted and baseline thyroid function testing showed undetectable free thyroxine and thyroid-stimulating hormone (TSH), prompting further endocrine investigation. Triiodothyronine (T3) was markedly raised with normal TSH receptor antibodies, and the patient later confessed to supplementary testosterone and T3 use as part of bodybuilding activities. Following counselling, thyroid function normalised and the patient returned to his usual health. This case describes the diagnostic work up in a case of persistent tachycardia caused by T3 supplementation, demonstrating the potential for endocrine supplementation by bodybuilders which may be poorly understood and recognised by clinicians. T3 supplementation should be considered and a thorough drug history obtained in bodybuilders presenting with symptoms of thyrotoxicosis and deranged thyroid function tests.

Indexed as

AdultAthletesDelayed DiagnosisDiagnosis, DifferentialHumansMaleSepsisTachycardiaTestosterone CongenersThyroid Function TestsThyrotoxicosisTriiodothyronineWeight LiftingTestosterone CongenersTriiodothyroninedrug misuse (including addiction)drugs in sport/doping controlendocrine systemthyroid diseasethyrotoxicosis

Identifiers

PMID31937628
PMCPMC7035845
OpenAlexW2998965358

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.