LETTER
Reevaluation of Amiodarone
Zia Ahmed, MD, and
Joel M. Goldman, MD
15 November 1995 | Volume 123 Issue 10 | Page 809
TO THE EDITOR:
In his comprehensive review of amiodarone, Dr. Podrid [1] discusses minor thyroid abnormalities, particularly the elevation of thyroid-stimulating hormone (TSH) levels. He does not mention the more common and more problematic elevation in thyroxine levels. Elevation of TSH levels is only transient, and levels gradually return to pretreatment values [2, 3]. In contrast, thyroxine and free thyroxine levels remain elevated [2, 3]. This condition can be confused with hyperthyroidism, which also occurs in a few patients receiving amiodarone. It can be difficult to distinguish between a euthyroid patient receiving amiodarone and an amiodarone-treated patient who has become hyperthyroid [3, 4]. Ultrasensitive TSH assays and measurement of triiodothyronine and free triiodothyronine levels can be useful in this setting [3, 4].
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Author and Article Information
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Brookdale Hospital Medical Center; Brooklyn, NY 11212
1. Podrid PJ. Amiodarone: reevaluation of an old drug. Ann Intern Med. 1995; 122:689-700.
2. Nademanee K, Piwonka RW, Singh BN, Hershman JM. Amiodarone and thyroid function. Prog Cardiovasc Dis. 1989; 31:427-37.
3. Wiersinga WM, Trip MD. Amiodarone and thyroid hormone metabolism. Postgrad Med J. 1986; 62:909-14.
4. Lombardi A, Martino E, Braverman LE. Amiodarone and the thyroid. Thyroid Today. 1990; 13:1-7.
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