Should a patient with anorexia nervosa be treated with levothyroxine?

In cases of anorexia nervosa, the primary focus of treatment is nutritional rehabilitation rather than pharmacological interventions like levothyroxine. Anorexia nervosa is an eating disorder characterized by severe restriction of food intake, leading to malnutrition, and a range of physical and psychological consequences.

Treating anorexia nervosa effectively involves re-establishing normal eating patterns and ensuring adequate nutritional intake to reverse the physiological effects of starvation. While hypothyroidism can occur in individuals with anorexia due to the impact of malnutrition on thyroid function, administering levothyroxine is not a standard treatment approach. Instead, the emphasis is placed on restoring nutritional status first, which can often normalize thyroid levels without the need for thyroid hormone replacement.

If thyroid hormone levels are monitored, any abnormalities may correct themselves with proper nutritional support, making hormone replacement unnecessary unless there are clear indications of primary hypothyroidism independent of nutritional status. Therefore, prioritizing nutritional rehabilitation directly addresses the root of the disorder, aiding in weight restoration, and enhancing recovery, which is essential in the treatment of anorexia nervosa.