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Two cases of statin-induced myopathy caused by induced hypothyroidism
Howard M Lando1, Kenneth D Burman
1Department of Medicine, George Washington University, Alexandria, VA 22306, USA.
Objective:
To present information regarding the potential danger of performing levothyroxine withdrawal radioiodine scans and treatment in patients with thyroid cancer who are concurrently taking lipid-lowering agents.
Methods:
We review the clinical history, serial laboratory data, and radiologic findings in 2 patients with multifocal papillary carcinoma of the thyroid.
Results:
Both study patients had substantial elevations of muscle enzymes or myopathies (or both) when they were withdrawn from levothyroxine therapy, during treatment with lipid-lowering agents, in preparation for radioiodine scanning and treatment.
Conclusion:
Extreme caution should be exercised when levothyroxine therapy is withdrawn from patients taking lipid-lowering agents. Such patients should be monitored very closely or, when appropriate, recombinant human thyroid-stimulating hormone injections should be used rather than levothyroxine withdrawal in this setting.
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