Date of download: 9/17/2016 From: Effects of Amiodarone on Thyroid Function Ann Intern Med. 1997;126(1):63-73. doi:10.7326/0003-4819-126-1-199701010-00009.

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Date of download: 9/17/2016 From: Effects of Amiodarone on Thyroid Function Ann Intern Med. 1997;126(1): doi: / Chemical structures of thyroxine, triiodothyronine, and amiodarone. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

Date of download: 9/17/2016 From: Effects of Amiodarone on Thyroid Function Ann Intern Med. 1997;126(1): doi: / Changes in thyroid hormone physiology and thyroid function test results in euthyroid patients who received amiodarone.43334The following changes in thyroid function test results occur: 1) increase in serum levels of thyroxine (T ) and reverse triiodothyronine [rT ], 2) initial increase followed by normalization of serum levels of thyroid-stimulating hormone [TSH], and 3) decrease in serum levels of triiodothyronine (T ). Asterisks indicate steps in thyroid hormone dynamics inhibited by amiodarone. Daggers indicate physiologic feedback inhibition. Bold arrow indicates that most feedback inhibition of TSH production is mediated by T rather than T. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

Date of download: 9/17/2016 From: Effects of Amiodarone on Thyroid Function Ann Intern Med. 1997;126(1): doi: / Suggested algorithm for evaluation and management of thyroid dysfunction in patients treated with amiodarone.43*Test should be done to serve as a reference for comparison with future test results. † Goal is to increase serum levels of thyroxine (T ) to high normal or slightly above normal (normalization of levels of thyroid-stimulating hormone [TSH] should not be attempted). ‡ Combination of thionamides (methimazole, 40 mg/d, or propylthiouracil, 400 to 800 mg/d) with potassium perchlorate (800 to 1000 mg/d for 15 to 45 days) or prednisone (0.5 to 1.25 mg/kg of body weight per day for 40 days) is beneficial; β-blockers may be added. AIH = amiodarone-induced hypothyroidism; AIT = amiodarone-induced thyrotoxicosis; T = triiodothyronine. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

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