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Amiodarone and Thyroid Function
- Kishore J. Harjai, MD; and
- Angelo A. Licata, MD, PhD
- Ochsner Medical Institutions; New Orleans, LA 70121 Cleveland Clinic Foundation; Cleveland, OH 44195
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IN RESPONSE:
Dr. Biddle raises an appropriate question about the use of replacement therapy with triiodothyronine or triiodothyronine and thyroxine (rather than thyroxine alone) in patients with amiodarone-induced hypothyroidism, given that amiodarone inhibits peripheral deiodination of thyroxine to triiodothyronine. We know of no clinical studies that have used triiodothyronine or triiodothyronine and thyroxine in patients with amiodarone-induced hypothyroidism.
We do wish to point out that serum total and free triiodothyronine concentrations are within the normal range in about half of all patients, and serum thyroxine (total and free) concentrations are usually decreased in patients with amiodarone-induced hypothyroidism [1]. Hence, this situation is somewhat different from the cases for which Biddle has reported good results with triiodothyronine or triiodothyronine and thyroxine, cases that are characterized by “normal free thyroxine levels, and low free triiodothyronine levels … .” Nonetheless, in patients with amiodarone-induced hypothyroidism and low serum levels of thyroxine and triiodothyronine, the potential advantages of combined triiodothyronine and thyroxine preparations need further exploration.
Kishore J. Harjai, MD
Ochsner Medical Institutions; New Orleans, LA 70121
Angelo A. Licata, MD, PhD
Cleveland Clinic Foundation; Cleveland, OH 44195
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
