Gastroparesis: A Novel Cause of Persistent Thyroid Stimulating Hormone Elevation in Hypothyroidism

The document reported a case of a 77-year-old man with hypothyroidism who experienced persistent elevation of thyroid stimulating hormone (TSH) despite being compliant with levothyroxine therapy. The patient required higher than usual doses of thyroxine due to malabsorption, which was linked to gastroparesis, a condition confirmed by a gastric emptying study. This case was significant as it was the first documented association between gastroparesis and thyroxine malabsorption, suggesting that gastroparesis should be considered in patients with persistent TSH elevation despite standard thyroxine doses.