Amiodarone-induced thyreopaties
Authors:
Adela Krausová
Authors‘ workplace:
3. interní klinika – klinika endokrinologie a metabolismu 1. LF UK a VFN v Praze
Published in:
Čas. Lék. čes. 2025; 164: 94-99
Category:
Review Article
Overview
Amiodarone-induced thyroid dysfunction represents a serious complication of treatment with amiodarone, a frequently used potent antiarrhythmic drug. In clinical practice, there are two main forms: hypothyroidism and hyperthyroidism. Amiodarone-induced thyrotoxicosis is further divided into type 1 and type 2 with different pathogenesis, diagnostic findings and, most importantly for the patient, therapeutic approach. Due to frequent diagnostic overlap, a mixed form of amiodarone-induced thyrotoxicosis is also recognized, requiring a combination of both distinct treatment strategies, antithyroid drugs and glucocorticoids.
Amiodarone-induced type 1 thyrotoxicosis necessitates prospective discontinuation of amiodarone therapy; in type 2 this step is usually not warranted. In hypothyroidism, substitution therapy with levothyroxine is sufficient without the need to stop antiarrhythmic treatment with amiodarone. Amiodarone-induced thyrotoxicosis may significantly increase the incidence of cardiovascular complications. If amiodarone treatment is discontinued solely for cardiological indications, patients without a history of thyroid disease usually experience restoration of normal thyroid function. However, in predisposed individuals, dysfunction may persist or recur following repeated iodine exposure.
Keywords:
amiodarone, thyroid gland; thyroid dysfunction, hypothyroidism, thyrotoxicosis
Sources
- Ross DS. Amiodarone and thyroid dysfunction. UpToDate, 2024. Dostupné na: www.uptodate.com/contents/amiodarone-and-thyroid-dysfunction
- Trip MD, Wiersinga W, Plomp TA. Incidence, predictability, and pathogenesis of amiodarone-induced thyrotoxicosis and hypothyroidism. Am J Med 1991; 91: 507–511.
- Harjai KJ, Licata AA. Effects of amiodarone on thyroid function. Ann Intern Med 1997; 126: 63–73.
- Martino E, Safran M, Aghini-Lombardi F et al. Environmental iodine intake and thyroid dysfunction during chronic amiodarone therapy. Ann Intern Med 1984; 101: 28–34.
- Basaria S, Cooper DS. Amiodarone and the thyroid. Am J Med 2005; 118: 706–714.
- Ross DS, Burch HB, Cooper DS et al. 2016 American Thyroid Association Guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid 2016; 26: 1343–1421.
- Yiu KH, Jim MH, Siu CW et al. Amiodarone-induced thyrotoxicosis is a predictor of adverse cardiovascular outcome. J Clin Endocrinol Metab 2009; 94: 109–114.
- O’Sullivan AJ, Lewis M, Diamond T. Amiodarone-induced thyrotoxicosis: left ventricular dysfunction is associated with increased mortality. Eur J Endocrinol 2006; 154: 533–536.
- Tomisti L, Rossi G, Bartalena L et al. The onset time of amiodarone-induced thyrotoxicosis (AIT) depends on AIT type. Eur J Endocrinol 2014; 171: 363–368.
- Bartalena L, Chiovato L, Croce L et al. Management of amiodarone-associated thyroid dysfunction: an expert consensus statement from the European Thyroid Association (ETA). Eur Thyroid J 2018; 7: 55–66.
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistArticle was published in
Journal of Czech Physicians
- Metamizole vs. Tramadol in Postoperative Analgesia
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Advances in the Treatment of Myasthenia Gravis on the Horizon
- Current Insights into the Antispasmodic and Analgesic Effects of Metamizole on the Gastrointestinal Tract
- Spasmolytic Effect of Metamizole
Most read in this issue
- Shooting at the Faculty of Arts of Charles University and activation of the trauma plan at the First Surgical Clinic of the General Teaching Hospital
- Amiodarone-induced thyreopaties
- Clinical obesity – finally a change of paradigm? From BMI to chronic disease
- Comparison of performance between artificial intelligence and radiologists in detecting abnormalities on chest X-rays