Background: Thyrotoxic hypokalemic periodic paralysis (THPP) is a rare complication of hyperthyroidism and is marked by thyrotoxicosis, hypokalemia, and paralysis. It is the most commonly acquired form of periodic paralysis. It has been most commonly reported in Asian subjects, with limited information on the black population. This is precipitated by strenuous exercise, high carbohydrates, stress, infection, alcohol, albuterol, and corticosteroid therapy. Case Presentation: We present a 29-year-old male patient admitted from the emergency department with a complaint of sudden onset of paralysis after a high carbohydrate meal. Laboratory investigations showed low potassium chloride 1.8 mEq/l, TSH 0.006 miu/l, T3 3.2 ng/ml. T4 13.5 ng/ml. Potassium chloride infusion and antithyroid drugs were given. Conclusion: To prevent deadly consequences (cardiac and respiratory), it is critical to diagnose THPP early and treat the electrolyte imbalance that is precipitated by strenuous exercise and high carbohydrate meals.

Background Thyrotoxic hypokalemic periodic paralysis (THPP) is a rare complication of hyperthyroidism characterized by thyrotoxicosis, hypokalemia, and paralysis. It is the most common form of acquired periodic paralysis. THPP is precipitated by strenuous exercise, a high carbohydrate diet, stress, infection, alcohol, albuterol, and corticosteroid therapy. It is most common in Asian men with hyperthyroidism and exceptionally rare in black people. Case Presentation A 29-year-old man was admitted to the emergency department in Somalia with a sudden onset of paralysis after a high carbohydrate meal. Laboratory investigations showed low serum potassium 1.8 mEq/l (3.5–4.5), and biochemical thyrotoxicosis with TSH 0.006 miu/l (0.35–5.1), total T3 3.2 ng/ml (0.9–2.8) and total T4 13.5 ng/ml (0.6–1.2). He was successfully treated with potassium chloride infusion and an antithyroid drug, methimazole. Conclusion To prevent life-threatening cardiac and respiratory complications, it is critical to consider and diagnose THPP early, even in populations where the condition is rare.