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Related Experiment Videos

Drug-induced hypothyroidism.

Leonardo F L Rizzo1, Daniela L Mana1, Héctor A Serra2

  • 1Dirección Médica Química Montpellier SA, Argentina.

Medicina
|October 19, 2017
PubMed
Summary
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Drug-induced thyroid dysfunction, primarily hypothyroidism, is a growing concern. Evaluating thyroid function before prescribing certain medications is crucial to prevent adverse effects and manage treatment interactions.

Area of Science:

  • Endocrinology
  • Pharmacology
  • Internal Medicine

Background:

  • The thyroid axis is susceptible to drug interactions, with an increasing number of medications affecting thyroid function.
  • Drug-induced thyroid dysfunction, predominantly hypothyroidism, is a significant clinical issue.
  • Understanding these interactions is vital for patient safety and effective treatment.

Purpose of the Study:

  • To review the mechanisms of drug-induced thyroid dysfunction, including primary and central hypothyroidism.
  • To highlight drugs that interfere with levothyroxine treatment.
  • To emphasize the importance of pre-prescription thyroid function evaluation.

Main Methods:

  • Literature review of drug-induced thyroid dysfunction.
  • Analysis of mechanisms: hormone synthesis inhibition, immune responses, receptor blockade.
Keywords:
drugshypothyroidismthyroid

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  • Identification of drugs affecting thyroid hormone absorption, transport, and metabolism.
  • Main Results:

    • Primary hypothyroidism mechanisms include synthesis inhibition, immune reactions (interferon, cytokines), and drug-induced thyroiditis (tyrosine kinase inhibitors, VEGF inhibitors).
    • Central hypothyroidism can result from TSH inhibition (bexarotene, corticosteroids) or immunological effects (anti-CTLA4, anti-PD-1 antibodies).
    • Levothyroxine efficacy can be compromised by drugs affecting its absorption, transport, or metabolism.

    Conclusions:

    • Pre-prescription thyroid function assessment is strongly recommended for drugs like amiodarone, lithium, interferon, and new biological therapies.
    • Awareness of drug-endocrine interactions, particularly with thyroid function, is essential for clinicians.
    • Proactive monitoring and management are necessary to mitigate risks associated with drug-induced thyroid dysfunction.