NBME 4 Question - goatmilk

[ArchivalUser]

4-42) 42yo M with 3-month history of fatigue, generalized weakness, and depressed mood. Cold intolerance, muscle aches, and constipation. Follows a strict vegetarian diet. Wife has hypothyroidism rx with levothyroxine. Dry skin, testes are small. TSH if 0.1. T4 is 2.3. Mechanism?
A) Autoantibodies against thyroglobulin
B) Deficient pituitary production of TSH (correct answer)
C) Dietary deficiency of iodine
D) Increased production of thyroid-binding globulin
E) Surreptitious levothyroxine use

Is there a name for this disease??

What kind of TSH and T4 values should you be seeing in Surreptitious levothyroxine use??

[ArchivalUser]

anyone??

[ArchivalUser]

Well since the tsh and t4 values are both reduced it means the problem isn't a primary one . I would say secondary hypothyroidism so deficiency is from the pituitary .
In surreptitious levothyroxine use, the t4 levels will be high thereby suppressing the tsh level and you get atrophy of the thyroid gland too.