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Amiodarone-induced thyroid gland dysfunction.

S Mechlis, E Lubin, J Laor

    The American Journal of Cardiology
    |April 1, 1987
    PubMed
    Summary
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    Amiodarone treatment can cause thyroid dysfunction, including thyrotoxicosis and hypothyroidism. Monitoring total T3 and thyroid iodine levels helps identify patients at risk for amiodarone-induced thyrotoxicosis.

    Area of Science:

    • Endocrinology
    • Cardiology

    Background:

    • Amiodarone is an effective antiarrhythmic drug.
    • Amiodarone contains a high iodine content, which can affect thyroid function.
    • Thyroid dysfunction is a known side effect of amiodarone therapy.

    Purpose of the Study:

    • To evaluate the incidence and characteristics of thyroid dysfunction in patients treated with amiodarone.
    • To identify predictors of amiodarone-induced thyrotoxicosis.
    • To assess the effectiveness of interventions for amiodarone-induced thyroid dysfunction.

    Main Methods:

    • Retrospective analysis of 400 patients treated with amiodarone.
    • Thyroid function tests (including total T3) were performed on 97 patients.
    • In vivo x-ray fluorescence was used to measure thyroid iodine content in a subset of patients.

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    Main Results:

    • 20 patients (20.6%) developed thyrotoxicosis, and 16 (16.5%) developed hypothyroidism.
    • High total T3 was the most specific finding in thyrotoxic patients, who also had high thyroid iodine levels.
    • Hypothyroid patients showed high thyroid-stimulating hormone; treatment involved hormone replacement and/or amiodarone withdrawal.
    • Thyroid function normalized 3-7 months after amiodarone cessation.

    Conclusions:

    • Amiodarone frequently causes thyroid dysfunction, with thyrotoxicosis being characterized by elevated total T3 and high thyroid iodine levels.
    • Patients with increasing total T3 and high thyroid iodine levels during amiodarone treatment are at high risk for thyrotoxicosis.
    • Reducing the amiodarone maintenance dose may be beneficial for at-risk patients.