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Thyroid Diseases pp 733–761Cite as

Drugs and Other Substances Interfering with Thyroid Function

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Part of the book series: Endocrinology ((ENDOCR))

Abstract

Several drugs and supplements may interfere, at different levels, with regulation of thyroid function. Some drugs may also cause thyroid autoimmunity. This chapter reviews drugs that significantly affect thyroid function. Glucocorticoids, dopamine agonists, somatostatin analogs, and retinoids inhibit TSH secretion. Lithium, tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs), antiepileptics, rifampin, metformin, and amiodarone mainly affect directly thyroid function. Interferon-α and antiretroviral drugs may have several effects, including inducing thyroid autoimmunity. The heterogeneous adverse effects induced by antineoplastic agents (cytotoxic and novel anticancer agents, tyrosine kinase inhibitors, bexarotene- and iodine-based cancer therapies, and radioimmunotherapies) will be highlighted. Immunoregulatory drugs (IL-2, denileukin diftitox, thalidomide and lenalidomide, IFN-α, alemtuzumab) and immune checkpoint inhibitors (anti-CTLA4 and anti-PD-1 monoclonal antibodies) mainly promote thyroid autoimmunity. The effects of endocrine disruptors and nutraceuticals and over-the-counter products (selenium, L-carnitine, thyroid hormones, iodine, and biotin) will also be discussed. The last part of the chapter concerns drugs that interfere with levothyroxine (LT4) absorption.

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Endocrinology Unit 1, University Hospital of Pisa, Pisa, Italy

    Lucia Montanelli & Francesco Latrofa

  2. Department of Clinical and Experimental Medicine, Master Program of Childhood, Adolescent and Women’s Endocrine Health, Interdepartmental Program of Molecular and Clinical Endocrinology, and Women’s Endocrine Health, University of Messina and A.O.U. Policlinico G. Martino, Messina, Italy

    Salvatore Benvenga

  3. Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

    Laszlo Hegedüs

  4. Evgenideion Hospital, Unit of Endocrinology, Diabetes and Metabolism, University of Athens, Athens, Greece

    Leonidas H. Duntas

  5. Department of Endocrinology, University of Pisa, Pisa, Italy

    Paolo Vitti

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  1. Lucia Montanelli
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  2. Salvatore Benvenga
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  3. Laszlo Hegedüs
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  4. Paolo Vitti
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  5. Francesco Latrofa
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  6. Leonidas H. Duntas
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Correspondence to Lucia Montanelli .

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Editors and Affiliations

  1. Department of Endocrinology, University of Pisa, Pisa, Italy

    Paolo Vitti

  2. Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

    Laszlo Hegedüs

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Montanelli, L., Benvenga, S., Hegedüs, L., Vitti, P., Latrofa, F., Duntas, L.H. (2018). Drugs and Other Substances Interfering with Thyroid Function. In: Vitti, P., Hegedüs, L. (eds) Thyroid Diseases. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-45013-1_27

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  • DOI: https://doi.org/10.1007/978-3-319-45013-1_27

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