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Drugs and Other Substances Interfering with Thyroid Function

  • Lucia Montanelli
  • Salvatore Benvenga
  • Laszlo Hegedüs
  • Paolo Vitti
  • Francesco Latrofa
  • Leonidas H. Duntas
Reference work entry
First Online:
Part of the Endocrinology book series (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.

Keywords

Alemtuzumab Amiodarone Anti-CTLA4 monoclonal antibodies Anti-PD-1 monoclonal antibodies Bexarotene Cytotoxic agents Denileukin diftitox Dopamine Endocrine disruptors Glucocorticoids IFN-α IL-2 Immune checkpoint inhibitors Inositol Interferons L-carnitine Lenalidomide Levothyroxine sodium Lithium Metformin Nutraceuticals Rexinoids Rifampin Selective serotonin reuptake inhibitors Selenium Somatostatin Thalidomide Tricyclic antidepressants Tyrosine kinase inhibitors 
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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Lucia Montanelli
    • 1
  • Salvatore Benvenga
    • 2
  • Laszlo Hegedüs
    • 3
  • Paolo Vitti
    • 5
  • Francesco Latrofa
    • 1
  • Leonidas H. Duntas
    • 4
  1. 1.Department of Clinical and Experimental Medicine, Endocrinology Unit 1University Hospital of PisaPisaItaly
  2. 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 HealthUniversity of Messina and A.O.U. Policlinico G. MartinoMessinaItaly
  3. 3.Department of Endocrinology and MetabolismOdense University HospitalOdenseDenmark
  4. 4.Evgenideion Hospital, Unit of Endocrinology, Diabetes and MetabolismUniversity of AthensAthensGreece
  5. 5.Department of EndocrinologyUniversity of PisaPisaItaly

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