Hashimoto’s thyroiditis aggravated by goitrogenic diet presenting as rhabdomyolysis worsened by alcohol intake

Abstract

Hashimoto’s thyroiditis (HT) is the most common form of primary hypothyroidism. Several muscular manifestations like pain, weakness, stiffness and elevated muscle enzymes have been noticed in hypothyroidism. Alcohol is also known to cause myositis and rhabdomyolysis. Patients with thyroid should avoid certain foods like broccoli, cauliflower and cabbage as they contain goitrogens. This is a case of a young man who presented with severe muscle aches and pain and was found to have rhabdomyolysis. Further evaluation revealed an underlying HT. Moreover, he had been consuming raw broccoli, which is goitrogenic, and alcohol which worsened the rhabdomyolysis. He was managed with levothyroxine and intravenous fluids, following which he improved.