http://www.canada.com/health/story.html?id=3A0F3479-37BE-4886-8C98-0D8B373A0281
'Hamburger thyrotoxicosis' joins list of bizarre cases
OTTAWA - A Timmins physician with a knack for spotting unusual cases has made the pages of the Canadian Medical Association Journal for the third time in less than a year.
Dr. Malvinder Parmar, an internal medicine specialist at Timmins and District Hospital, first came across the man who talked on the phone with his neck crooked to the side for so long he had a stroke.
Then came the chubby women who wore jeans slung so low and tight they suffered nerve damage that set their thighs tingling.
Now Dr. Parmar offers the case of a Timmins-area woman who began to sweat, shake and suffer heart palpitations after eating
hamburger patties inadvertently contaminated with a cow's thyroid gland.
The 61-year-old woman developed, over a period of 11 years, five bouts of "hamburger thyrotoxicosis." The condition results from eating beef containing ground-up cow thyroid tissues.
The woman kept returning to doctors with symptoms of an overactive thyroid gland, such as excessive sweating, rapid weight loss and tremors.
The thyroid sits in the lower front of the neck. It churns out a hormone called thyroxine, which keeps cells in tissues and organs in the body functioning properly.
The woman first became ill in 1990. A blood test revealed elevated levels of "free T," or free thyroxine. But, within two months, she was back to normal.
She was referred to a specialist in Toronto, who diagnosed "subacute thyroiditis" -- an inflammation of the thyroid gland that usually clears up spontaneously within three to six months.
When the symptoms returned in 1993, she was referred to Dr. Parmar, one of only two specialists in internal medicine in the Timmins area. After the tremors and heart palpitations stopped again within a few months, Dr. Parmar assumed it was just another bout of thyroiditis. Then, in 1998, she was back in his office again. This time, blood tests suggested the woman might be using thyroid medications to try to lose weight, since the tests revealed the excess hormones were not endogenous, meaning coming from her own body, but exogenous, or coming from an outside source.
"We questioned her, and she said, 'no, doctor.' And she was quite sincere," Dr. Parmar said in an interview.
After she returned a fourth, then a fifth time, Dr. Parmar was rattled. When he started asking her about her diet, he discovered the woman lived on a farm, and that every few years she and her husband slaughtered one of their cows. The meat was sent to a local butcher, who wasn't aware of the rule against "gullet trimming," where muscles from the animal's larynx are harvested. The butcher had inadvertently used the neck trimmings to make hamburger patties.
The woman's husband never became ill, because he stuck to steaks and ribs.
The patties couldn't be tested to confirm they were contaminated with cow thyroid glands because by the time they were suspected, the last batch had already been eaten.
"However, the temporal association of episodes of transient hyperthyroidism with availability of meat from a slaughtered cow over the previous 11 years is highly supportive of hamburger thyrotoxicosis," Dr. Parmar and his co-author, Dr. Cecil Sturge, report in today's journal.
Dr. Parmar recalled the outbreaks of hamburger thyrotoxicosis that occurred in Minnesota, South Dakota and Iowa in the mid-1980s after people ate ground beef containing bovine thyroid gland. That led to the ban of gullet trimming in all plants that slaughter cattle and pigs. The Canadian Food Inspection Agency says it is standard practice in Canadian slaughtering plants to remove the neck from animals to ensure it does not enter the food chain.
In addition to his recent journal articles on "telephone stroke" and the hazards of hip hugger jeans, Dr. Parmar has also reported on "killer dreams" (nightmares so terrifying they trigger heart attacks) and "snowmobiler's hematuria" (blood in the urine caused by long-distance snowmobile rides).
'Hamburger thyrotoxicosis' joins list of bizarre cases
OTTAWA - A Timmins physician with a knack for spotting unusual cases has made the pages of the Canadian Medical Association Journal for the third time in less than a year.
Dr. Malvinder Parmar, an internal medicine specialist at Timmins and District Hospital, first came across the man who talked on the phone with his neck crooked to the side for so long he had a stroke.
Then came the chubby women who wore jeans slung so low and tight they suffered nerve damage that set their thighs tingling.
Now Dr. Parmar offers the case of a Timmins-area woman who began to sweat, shake and suffer heart palpitations after eating
hamburger patties inadvertently contaminated with a cow's thyroid gland.
The 61-year-old woman developed, over a period of 11 years, five bouts of "hamburger thyrotoxicosis." The condition results from eating beef containing ground-up cow thyroid tissues.
The woman kept returning to doctors with symptoms of an overactive thyroid gland, such as excessive sweating, rapid weight loss and tremors.
The thyroid sits in the lower front of the neck. It churns out a hormone called thyroxine, which keeps cells in tissues and organs in the body functioning properly.
The woman first became ill in 1990. A blood test revealed elevated levels of "free T," or free thyroxine. But, within two months, she was back to normal.
She was referred to a specialist in Toronto, who diagnosed "subacute thyroiditis" -- an inflammation of the thyroid gland that usually clears up spontaneously within three to six months.
When the symptoms returned in 1993, she was referred to Dr. Parmar, one of only two specialists in internal medicine in the Timmins area. After the tremors and heart palpitations stopped again within a few months, Dr. Parmar assumed it was just another bout of thyroiditis. Then, in 1998, she was back in his office again. This time, blood tests suggested the woman might be using thyroid medications to try to lose weight, since the tests revealed the excess hormones were not endogenous, meaning coming from her own body, but exogenous, or coming from an outside source.
"We questioned her, and she said, 'no, doctor.' And she was quite sincere," Dr. Parmar said in an interview.
After she returned a fourth, then a fifth time, Dr. Parmar was rattled. When he started asking her about her diet, he discovered the woman lived on a farm, and that every few years she and her husband slaughtered one of their cows. The meat was sent to a local butcher, who wasn't aware of the rule against "gullet trimming," where muscles from the animal's larynx are harvested. The butcher had inadvertently used the neck trimmings to make hamburger patties.
The woman's husband never became ill, because he stuck to steaks and ribs.
The patties couldn't be tested to confirm they were contaminated with cow thyroid glands because by the time they were suspected, the last batch had already been eaten.
"However, the temporal association of episodes of transient hyperthyroidism with availability of meat from a slaughtered cow over the previous 11 years is highly supportive of hamburger thyrotoxicosis," Dr. Parmar and his co-author, Dr. Cecil Sturge, report in today's journal.
Dr. Parmar recalled the outbreaks of hamburger thyrotoxicosis that occurred in Minnesota, South Dakota and Iowa in the mid-1980s after people ate ground beef containing bovine thyroid gland. That led to the ban of gullet trimming in all plants that slaughter cattle and pigs. The Canadian Food Inspection Agency says it is standard practice in Canadian slaughtering plants to remove the neck from animals to ensure it does not enter the food chain.
In addition to his recent journal articles on "telephone stroke" and the hazards of hip hugger jeans, Dr. Parmar has also reported on "killer dreams" (nightmares so terrifying they trigger heart attacks) and "snowmobiler's hematuria" (blood in the urine caused by long-distance snowmobile rides).