amiodarone induced hyperthyroidism

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  • incidence
    • in areas with high iodine intake - 1.7%
    • in areas with low iodine intake - 12%
  • pathogenesis
    • type 1 - occurs particularly in patients with underlying thyroid disease; iodine induced excessive synthesis of thyroid hormone
    • type 2 - destructive thyroiditis (amiodarone induced); occurs in patients with no previous underlying thyroid disease; thyroiditis results in release of thyroid hormones into the circulation
  • diagnosis
    • suppressed TSH levels; increased T3 and T4
    • fine needle aspiration - will yield evidence of thyroiditis
  • treatment
    • if possible withdrawal of amiodarone - note that withdrawal has no immediate effect because of very long half life of amiodarone
    • type 1 - first line therapy is use of antithyroid drugs; steroid treatment may be used in addition
    • type 2 - steroid treatment

Last reviewed 07/2021