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Amiodarone-induced thyroid dysfunction

U Khanderia¹, C A Jaffe, V Theisen

¹College of Pharmacy, University of Michigan, Ann Arbor.

Clinical Pharmacy

|October 1, 1993

Summary

Amiodarone, an antiarrhythmic drug, can cause thyroid dysfunction, leading to hypothyroidism or hyperthyroidism. Early recognition and management are crucial for patient outcomes.

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Area of Science:

Cardiology
Endocrinology
Pharmacology

Background:

Amiodarone is a potent antiarrhythmic medication used for managing cardiac arrhythmias.
Thyroid dysfunction is a known potential adverse effect of amiodarone therapy.

Observation:

Two cases illustrate amiodarone-induced thyroid dysfunction: hypothyroidism in a patient with ventricular tachycardia and hyperthyroidism in a patient with atrial fibrillation.
Symptoms included fatigue, cold intolerance (hypothyroidism), and sweating, heat intolerance, restlessness (hyperthyroidism).

Findings:

Amiodarone-induced hypothyroidism was characterized by elevated thyroid-stimulating hormone (TSH) levels and treated with levothyroxine.
Amiodarone-induced hyperthyroidism presented with signs of a hypermetabolic state and was managed with antithyroid drugs and propranolol.
The high iodine content of amiodarone is implicated in the mechanism of thyroid dysfunction.

Implications:

Amiodarone therapy necessitates vigilant monitoring of thyroid function due to the risk of hypothyroidism and hyperthyroidism.
Prompt diagnosis and appropriate management of amiodarone-induced thyroid dysfunction are essential to prevent serious complications.
Understanding the mechanisms and clinical presentations aids in effective patient care.

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