Heart Drugs and Influences on TH Metabolism

  • Fausto BogazziEmail author
  • Daniele Cappellani


Antiarrhythmic drugs, particularly amiodarone, may influence thyroid hormone metabolism and are, sometimes, responsible for overt thyroid dysfunction.

The effects of amiodarone on the thyroid have been extensively studied over the last decades. Changes of thyroid hormone concentrations (increased FT4 and low-to-normal FT3) occur in euthyroid patients during amiodarone therapy due to the inhibiting effect of the drug on peripheral metabolism of thyroid hormones. However, about 15% of the patients develop a thyroid disorder, either amiodarone-induced hypothyroidism (AIH) or amiodarone-induced thyrotoxicosis (AIT), mainly depending on iodine-supply. AIT, which can occur in the form of a true hyperthyroidism (type 1 AIT), or in that of a destructive thyroiditis (type 2 AIT), may represent a life-threatening condition, whose diagnosis and management is still challenging.

Dronedarone, the non-iodinated analog of amiodarone, has no relevant clinical thyroidal side effects, even though a possible interaction with thyroid hormone receptor has been proposed.


Amiodarone Dronedarone Thyroid Thyrotoxicosis AIT Hypothyroidism AIH 



Conflict of interest statement: The authors have nothing to disclose.


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Clinical and Experimental Medicine, Unit of EndocrinologyUniversity of PisaPisaItaly

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