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23rd May 2025

Drugs and thyroid function

Lots of medications can affect thyroid gland function either through acting centrally on the hypothalamic-pituitary-thyroid axis or via acting directly on the thyroid gland. Some of these medications are shown in Table 7:

Medication Type of thyroid dysfunction noted Any required monitoring
Amiodarone
  • Amiodarone has a high iodine content. Abnormalities in the form of hypo or hyperfunction of the gland are noted.
  • Wolff-Chaikoff effect occurs where acute inhibition of TPO leads to inhibition of thyroid hormone synthesis.
  • Sometimes Iodine excess contributes to thyrotoxicosis (Jod-Basedow phenomenon)
  • AIH (amiodarone induced hypothyroidism) is noted in areas with high iodine intake.
  • AIT (amiodarone induced thyrotoxicosis) occurs more frequently in regions with low iodine intake.
  • TFTs should be monitored prior to initiating amiodarone and every 6 months.
Iodine containing drugs used in CT imaging and cholecystography
  • Same phenomena described with amiodarone can occur. Hence, a hypo or hyperfunction of the gland can occur.
  • These phenomena are particularly expressed in patients with pre-existing thyroid disorder.
Lithium
  • Causes goitre and hypothyroidism picture by reducing thyroxine release via colloid pinocytosis inhibition.
  • Lithium is noted to cause painless thyroiditis.
  • Thyroid function testing before treatment initiation and every 6 months during treatment is recommended.
  • More regular TFTs monitor is required in impaired thyroid function conditions.

Table 7: Medications and their effect on thyroid gland function

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