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The effects of amiodarone on thyroid function

N S Jaggarao, J Sheldon, E N Grundy

Postgraduate Medical Journal

|November 1, 1982

Summary

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Amiodarone impacts thyroid function tests, potentially causing hypothyroidism or misleading thyrotoxicosis results. Regular thyroid monitoring is recommended for patients on amiodarone therapy.

Area of Science:

Endocrinology
Pharmacology
Internal Medicine

Background:

Amiodarone is an effective antiarrhythmic drug.
Its use is associated with various side effects, including thyroid dysfunction.

Purpose of the Study:

To investigate the effects of amiodarone on thyroid function tests.
To determine the clinical relevance of observed thyroid function test abnormalities.

Main Methods:

Prospective study of 100 patients treated with amiodarone for 6 weeks to 8 years.
Thyroid function tests including free thyroxine index, total tri-iodothyronine, thyrotrophin releasing hormone (TRH), and reverse tri-iodothyronine were analyzed.
Comparison with healthy subjects receiving amiodarone or iodine.

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Main Results:

One patient became thyrotoxic; 10 developed hypothyroidism.
25% of patients showed elevated free thyroxine indices despite being clinically euthyroid.
Amiodarone significantly raised reverse tri-iodothyronine in healthy subjects, unlike iodine alone.

Conclusions:

Amiodarone-induced thyroid dysfunction can manifest as hypothyroidism or misleadingly high thyroxine levels.
Peripheral conversion of thyroxine to tri-iodothyronine inhibition and increased reverse tri-iodothyronine contribute to these changes.
Annual thyroid function tests are crucial for amiodarone patients; hypothyroidism is clinically significant, while high thyroxine may not necessitate treatment cessation.