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J Pharm Pract 2021 Oct 29:8971900211054199. Epub 2021 Oct 29.

Department of Geriatric Medicine, 29241JSS Medical College & Hospital, JSS Academy of Higher Education and Research, Mysore, India.

Amiodarone is an antiarrhythmic drug belonging to Vaughan-Williams Class III with additional Class IV effects, which is known to cause many adverse drug reactions (ADRs) necessitating close monitoring. In about 20% of patients, their therapy is discontinued due to adverse effects such as hepatic impairment, thyroid dysfunction, and several pulmonary complications. Although dyselectrolytemia is a common adverse reaction reported with many cardiac medications, the incidence of hyponatremia associated with amiodarone intake is not reported widely in the literature. Read More

Clin Med (Lond) 2021 09;21(5):e529-e530

The Dudley Group NHS Foundation Trust, Dudley, UK

Amiodarone is a class 3 antiarrhythmic drug which may be associated with thyroid dysfunction. Amiodarone-induced thyrotoxicosis (AIT) is classified as type 1 (AIT 1; which may develop in the presence of latent autoimmune hyperthyroid condition) or type 2 (AIT 2; which develops in an apparently normal thyroid resulting from destructive thyroiditis). AIT 1 routinely requires treatment with thionamides, whereas AIT 2 is treated with steroids. Read More

Curr Opin Pediatr 2021 08;33(4):436-441

Division of Pediatric Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Purpose Of Review: Amiodarone-induced thyroid dysfunction is well established. The present review discusses recent literature related to the effects of amiodarone on the thyroid gland and thyroid function in pediatrics.

Recent Findings: Current guidelines in adults treated with amiodarone recommend baseline thyroid function testing followed by initiation of thyroid hormone monitoring after 3 months on therapy. Read More

Ther Adv Endocrinol Metab 2021 24;12:20420188211001165. Epub 2021 Apr 24.

Pediatric Endocrinology, Cliniques universitaires Saint Luc, Av. Hippocrate 10, Brussels, B-1200, Belgium.

Background: Amiodarone treatment is effective against various types of arrhythmias but is associated with adverse effects affecting, among other organs, thyroid function. Amiodarone-induced thyroid dysfunction was not thoroughly evaluated in children as it was in adults, yet this affection may lead to irreversible neurodevelopmental complications. Our study aimed to define the incidence and risk factors of amiodarone-induced thyroid dysfunction in children. Read More

Life Sci 2021 Jun 11;274:119344. Epub 2021 Mar 11.

Department of Pharmaceutics, Faculty of Pharmacy, Mansoura University, P.O. Box 35516, Mansoura, Egypt.

Aims: Amiodarone (AM) is a highly efficient drug for arrhythmias treatment, but its extra-cardiac adverse effects offset its therapeutic efficacy. Nanoparticles (NPs)-based delivery system could provide a strategy to allow sustained delivery of AM to the myocardium and reduction of adverse effects. The primary purpose was to develop AM-loaded NPs and explore their ameliorative effects versus off-target toxicities. Read More

BMC Cardiovasc Disord 2021 03 4;21(1):124. Epub 2021 Mar 4.

Department of Cardiovascular Medicine, Narita-Tomisato Tokushukai Hospital, 1-1-1 Hiyoshidai, Tomisato, Chiba, 286-0201, Japan.

Background: Thyroid storm (TS) is a rare but potentially life-threatening sequelae of untreated or undertreated hyperthyroidism. While TS frequently causes high-output heart failure, low-output heart failure related to dilated cardiomyopathy (DCM) is extremely rare. Tachycardia is a common clinical presentation of TS, and β1-selective blockers are the first-line agents for treating TS-associated tachycardia. Read More

Q J Nucl Med Mol Imaging 2021 Jun 26;65(2):124-131. Epub 2021 Jan 26.

Department of Endocrine Surgery, Third Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland -

Hyperthyroidism is a set of disorders that involve excess synthesis and secretion of thyroid hormones by the thyroid gland, which leads to thyrotoxicosis. The most common forms of hyperthyroidism include diffuse toxic goiter (Graves' disease), toxic multinodular goiter (Plummer disease), and a solitary toxic adenoma. The most reliable screening measure of thyroid function is the thyroid-stimulating hormone (TSH) level. Read More

J Clin Endocrinol Metab 2021 01;106(1):226-236

Endocrine Section, MedStar Washington Hospital Center, Washington, DC.

Amiodarone is a class III antiarrhythmic drug containing 37% iodine by weight, with a structure similar to that of thyroid hormones. Deiodination of amiodarone releases large amounts of iodine that can impair thyroid function, causing either hypothyroidism or thyrotoxicosis in susceptible individuals reflecting ~20% of patients administered the drug. Not only the excess iodine, but also the amiodarone (or its metabolite, desethylamiodarone) itself may cause thyroid dysfunction by direct cytotoxicity on thyroid cells. Read More

J Nucl Med 2021 03 2;62(3):304-312. Epub 2020 Oct 2.

Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York.

Benign thyroid disorders, especially hyper- and hypothyroidism, are the most prevalent endocrine disorders. The most common etiologies of hyperthyroidism are autoimmune hyperthyroidism (Graves disease, GD), toxic multinodular goiter (TMNG), and toxic thyroid adenoma (TA). Less common etiologies include destructive thyroiditis (e. Read More

Curr Opin Endocrinol Diabetes Obes 2020 10;27(5):329-334

Section of Endocrinology, Diabetes and Nutrition, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA.

Purpose Of Review: Amiodarone-induced thyroid dysfunction is well established and commonly encountered but is associated with several diagnostic and management challenges. The present review discusses recent evidence published related to the effects of amiodarone on the thyroid gland and thyroid function.

Recent Findings: Retrospective studies to evaluate amiodarone-induced thyroid dysfunction in children show the occurrence of potential clinically significant changes within 2 weeks of amiodarone initiation that may not be detected if standard adult guidelines for thyroid hormone monitoring are followed. Read More

J Clin Endocrinol Metab 2020 09;105(9)

Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Context: Patients with amiodarone-induced thyrotoxicosis (AIT) and severely reduced left ventricular ejection fraction (LVEF) have a high mortality rate that may be reduced by total thyroidectomy. Whether in this subset of patients thyroidectomy should be performed early during thyrotoxicosis or later after restoration of euthyroidism has not yet been settled.

Objectives: Mortality rates, including peritreatment mortality and 5-year cardiovascular mortality, and predictors of death, evaluated by Cox regression analysis. Read More

Med Klin Intensivmed Notfmed 2021 May 24;116(4):307-311. Epub 2020 Jun 24.

Klinik für Allgemeine Innere Medizin, Endokrinologie, Diabetologie, Infektiologie, Klinikum Bielefeld Mitte, Bielefeld, Deutschland.

Background: Iodine-induced thyroid dysfunctions are, despite their rare occurrence, important clinical syndromes. Their immediate recognition can avoid serious consequences. Important triggers can be iodine-containing contrast agents, amiodarone or iodine-containing disinfectants. Read More

Perit Dial Int 2020 07 10;40(4):422-424. Epub 2020 Feb 10.

Nephrology Department, Centro Hospitalar de Setubal EPE, Setubal, Portugal.

The residual renal function (RRF) in a peritoneal dialysis (PD) patient is clinically important because it contributes to dialytic adequacy, quality of life and mortality. We present the case of a patient in PD with a marked decrease in RRF. Even after the increase of dialysis, the patient maintained asthenia and anorexia, was prostrate and showed no improvement analytically. Read More

Georgian Med News 2019 Dec(297):84-87

Ivano-Frankivsk National Medical University, Ukraine.

The purpose of the work was to establish the frequency and conditions in which structural and functional changes of the liver might occur in case of long-term amiodarone use, depending on thyroid dysfunction. The study included 80 patients with cardiosclerosis with atrial fibrillation (AF). The patients were assigned to: group I (n=60) - received amiodarone at a maintenance dose for one year (on background of basic therapy); control group (CG) - patients (n=20) who received on the background of basic therapy digoxin and bisoprolol. Read More

Pediatr Rep 2019 Sep 24;11(3):8166. Epub 2019 Sep 24.

Unit of Pediatric Endocrinology, Centro Hospitalar de Lisboa Central, Lisbon.

Thyroid dysfunction is one of the most common adverse effects of amiodarone therapy, ranging from subclinical changes to overt clinical thyrotoxicosis (AIT) and/or hypothyroidism. Due to its heterogeneity, AIT lasts as a defiant entity, leading to a thorny treatment course, particularly in pediatrics. AIT can be classified as either type 1, type 2 or mixed form based on its pathophysiology. Read More

J Clin Endocrinol Metab 2020 01;105(1)

Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Context: It is not known whether total thyroidectomy is more favorable than medical therapy for patients with amiodarone-induced thyrotoxicosis (AIT).

Objective: To compare total thyroidectomy with medical therapy on survival and cardiac function in AIT patients.

Methods: Observational longitudinal cohort study involving 207 AIT patients that had received total thyroidectomy (surgery group, n = 51) or medical therapy (medical therapy group, n = 156) over a 20-year period. Read More

J Clin Endocrinol Metab 2019 11;104(11):5540-5546

Thyroid Center, Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Context: Amiodarone is used in patients with arrhythmias, but thyroid dysfunction [amiodarone-induced thyrotoxicosis (AIT) or amiodarone-induced hypothyroidism (AIH)] is a common adverse effect. As the onset of AIT and AIH has not been studied in children, the timing of dysfunction and long-term monitoring are not known in this population.

Objective: To describe the incidence and timing of amiodarone-induced thyroid dysfunction in children and adolescents, with a secondary aim to identify risk factors for amiodarone-induced thyroid dysfunction, and to identify variance in thyroid hormone surveillance and treatment. Read More

Endokrynol Pol 2019 5;70(5):392-400. Epub 2019 Jul 5.

Department of Paediatric and Adolescent Endocrinology, Paediatric Institute, Medical College, Jagiellonian University in Cracow, Cracow, Poland.

Introduction: Amiodarone is an important antiarrhythmic drug used in paediatric practice, mainly in children with complex congenital cardiac diseases and/or severe arrhythmias. One of the side effects of amiodarone therapy is thyroid dysfunction, which is observed in about 20% of patients. The thyroid dysfunction may present with various forms: from subclinical changes in hormone levels to amiodaroneinduced thyrotoxicosis (AIT) and amiodarone-induced hypothyroidism (AIH). Read More

Presse Med 2019 Apr 17;48(4):e199-e207. Epub 2019 Apr 17.

CHU Larrey, Department of endocrinology and metabolic diseases, 31059 Toulouse, France. Electronic address:

Introduction: Immunotherapy is a standard not only in second line but also in first line treatment in patients with non-small cell lung cancer (NSCLC) and other tumors. Thyroid dysfunctions are the most common endocrine toxicities.

Objective: To determine the incidence of thyroid dysfunctions during treatment with a PD-1 monoclonal antibody (nivolumab) in patients with NSCLC. Read More

Heart Rhythm 2019 09 21;16(9):1436-1442. Epub 2019 Mar 21.

Division of Pediatric Endocrinology and Metabolism, Mayo Clinic, Rochester, Minnesota. Electronic address:

Background: Heart Rhythm Society guidelines recommend obtaining thyroid function tests (TFTs) at amiodarone initiation and every 6 months thereafter in adults, with no specific pediatric recommendations. Untreated hypothyroidism in young children negatively affects brain development and somatic growth, yet the optimal screening frequency for pediatric patients remains unclear, and limited data exist on pediatric amiodarone-induced thyroid dysfunction.

Objective: The purpose of this study was to describe the patterns of amiodarone-induced thyroid dysfunction in pediatric patients. Read More

Trends Cardiovasc Med 2019 07 20;29(5):285-295. Epub 2018 Sep 20.

Divisions of Cardiology and Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States.

Although amiodarone is considered the most effective antiarrhythmic agent, its use is limited by a wide variety of potential toxicities. The purpose of this review is to provide a comprehensive "bench to bedside" overview of the ways amiodarone influences thyroid function. We performed a systematic search of MEDLINE to identify peer-reviewed clinical trials, randomized controlled trials, meta-analyses, and other clinically relevant studies. Read More

Presse Med 2018 Sep 28;47(9):746-756. Epub 2018 Sep 28.

CHU Clermont-Ferrand, service d'endocrinologie, diabétologie et maladies métaboliques, 63003 Clermont-Ferrand, France; Laboratoire GReD : UMR université Clermont Auvergne-CNRS 6293, Inserm U1103, BP 10448, 63177 Aubiere, France.

Amiodarone, a benzofuranic iodine-rich pan antiarrhythmic drug, is frequently associated with thyroid dysfunction. This side effect is heterogeneous and unpredicted, motivating regular evaluation of thyroid function tests. In contrary to hypothyroidism, amiodarone-induced thyrotoxicosis (AIT) is a challenging situation owing to the risk of deterioration of the general and cardiac status of such debilitating patients. Read More

Pediatr Cardiol 2018 Dec 21;39(8):1707-1716. Epub 2018 Sep 21.

Hospital for Children and Adolescents, University Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany.

Amiodarone-induced hyperthyroidism is a known side effect of amiodarone treatment. In the pediatric population, long-term amiodarone treatment is rarely indicated because of its severe side effects including thyroid function impairment. Treatment is therefore restricted to therapy-resistant arrhythmias. Read More

Congenit Heart Dis 2018 Nov 21;13(6):944-951. Epub 2018 Sep 21.

Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.

Objective: Amiodarone is a highly effective antiarrhythmic therapy, however its toxicity profile often limits treatment. This is particularly relevant in adults with congenital heart disease (CHD), who are often young and in whom other antiarrhythmic agents commonly fail or are contraindicated. We sought to determine incidence and predictors of adverse effects caused by amiodarone in adult CHD (ACHD). Read More

Heart Lung 2018 Jul - Aug;47(4):429-431. Epub 2018 May 21.

Department of Cardiology, New York Medical College, St. Joseph Medical Center, 703 Main Street, Paterson, NJ 07503, USA.

Amiodarone is a benzofuran derivative that contains 37% iodine by weight and is structurally similar to the thyroid hormones. Amiodarone has a complex effect on the thyroid gland, ranging from abnormalities of thyroid function tests to overt thyroid dysfunction, with either thyrotoxicosis or hypothyroidism. Myxedema coma secondary to amiodarone use has been rarely reported in the literature. Read More

Exp Clin Endocrinol Diabetes 2018 Jun 20;126(6):333-341. Epub 2018 Mar 20.

Department of Endocrinology, Diabetes & Metabolism, University Hospitals of Morecambe Bay NHS Foundation Trust, United Kingdom, LA1 4RP.

Amiodarone is one of the most commonly prescribed antiarrhythmic agents in clinical practice owing to its efficacy, even with high toxicity profile. The high iodine content and the prolonged biological half-life of the drug can result in thyroid dysfunction in a high proportion of patients treated with amiodarone even after cessation of amiodarone. Both hypothyroidism and hyperthyroidism are common side effects that mandate regular monitoring of patients with thyroid function tests. Read More

Pediatr Cardiol 2018 Jun 9;39(5):1016-1022. Epub 2018 Mar 9.

Department of Pediatric Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo, 183-0003, Japan.

Amiodarone (AMD) is a class III anti-arrhythmic drug that is highly effective for tachyarrhythmia treatment. AMD is widely used in adults with congenital heart disease (CHD); however, higher doses of AMD (> 200 mg/day) can cause various non-cardiac side effects. The purpose of this study was to assess the efficacy, safety, and adverse events of low-dose AMD (≤ 200 mg/day) for tachyarrhythmia in patients with CHD. Read More

J Community Hosp Intern Med Perspect 2017 14;7(6):369-371. Epub 2017 Dec 14.

Department of Internal Medicine, Tower Health: Reading Hospital, Reading, PA, USA.

Amiodarone is an effective medication used in the treatment of several different arrhythmias. Its most well-known adverse effects include pulmonary fibrosis, thyroid dysfunction, and hepatotoxicity. A less common side effect is acute pancreatitis. Read More

Adv Exp Med Biol 2018 ;1067:239-253

Cardiology Unit, Cardiothoracic Department, Policlinic University Hospital, Bari, Italy.

Among comorbidity in chronic heart failure (CHF), dysthyroidism represents a relevant problem especially in the ageing CHF patients worldwide. Thyroid greatly affects many cardiovascular activities and its dysfunction may worsen a CHF condition. In particular, hypothyroidism has a relative high prevalence in patients with heart failure and it plays a key role in influencing CHF onset, progression and prognosis. Read More

Curr Radiopharm 2017 Nov;10(3):146-154

Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania.

Background And Objective: The use of amiodarone for the treatment of ventricular and supraventricular dysrhythmias brings in organism an increased amount of iodine, interfering with thyroid function. If the treatment needs to be interrupted, iodine remains at abnormal levels for months or even years. The aim of the study was to review the literature regarding the optimal tests for early diagnostic and to analyze the role of nuclear medicine tests in the differential and correct assessment of the amiodarone-induced thyroid pathology. Read More