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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.<\/jats:p>","DOI":"10.1136\/bcr-2019-232867","type":"journal-article","created":{"date-parts":[[2020,1,14]],"date-time":"2020-01-14T05:45:22Z","timestamp":1578980722000},"page":"e232867","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Delayed diagnosis of T3 supplementation in a bodybuilder presenting with tachycardia and features of sepsis"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1897-4682","authenticated-orcid":false,"given":"Bronwen E","family":"Warner","sequence":"first","affiliation":[{"name":"Internal Medicine, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK"},{"name":"Acute General Medicine, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5134-7165","authenticated-orcid":false,"given":"Charles J","family":"Woodrow","sequence":"additional","affiliation":[{"name":"Nuffield Department of Clinical Medicine, Oxford, Oxfordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5854-8920","authenticated-orcid":false,"given":"Aparna","family":"Pal","sequence":"additional","affiliation":[{"name":"Radcliffe Department of Medicine, Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford, Oxfordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,1,13]]},"reference":[{"key":"2025082711084534000_13.1.e232867.1","first-page":"1347","article-title":"Supplement consumption in body builder athletes","volume":"16","author":"Karimian","year":"2011","journal-title":"J Res Med Sci"},{"key":"2025082711084534000_13.1.e232867.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2014.01.009"},{"key":"2025082711084534000_13.1.e232867.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.i5023","article-title":"Anabolic steroid use","volume":"355","author":"Brooks","year":"2016","journal-title":"BMJ"},{"key":"2025082711084534000_13.1.e232867.4","doi-asserted-by":"crossref","unstructured":"Hameed M , Sahu A , Johnson MB . 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