Li, Amio, I- causing hypothyroid OR hyperthyroid

[Trogghunter]

---

Members don't see this ad.

HOW do some iatrogenic causes cause both hypothyroidism and hyperthyroidism?
ie) Lithium, Amiodarone, Iodine.

Is there some refractory effect going on? I know that:
1) amiodarone has an iodine derivative that is uptaken in different ways and causes varied iodine uptake by the thyroid
2) Lithium affects how iodine is uptaken
3) Iodine---needless to say

My question is: has anyone ever come across the reason why the drugs will cause either hyper or hypo, as if it varies from person to person?

Thanks.

 

[redpanda]

HOW do some iatrogenic causes cause both hypothyroidism and hyperthyroidism?
ie) Lithium, Amiodarone, Iodine.

Is there some refractory effect going on? I know that:
1) amiodarone has an iodine derivative that is uptaken in different ways and causes varied iodine uptake by the thyroid
2) Lithium affects how iodine is uptaken
3) Iodine---needless to say

My question is: has anyone ever come across the reason why the drugs will cause either hyper or hypo, as if it varies from person to person?

Thanks.

As far as we were told in our endocrine course, whether you get hypothyroid or hyperthyroid from a big dose of iodine is idiosyncratic (Wolff-Chaikoff effect or Jod-Basedow effect, respectively). Probably the most you should know is to check the patient's med list very carefully any time they come in with something looking like a thyroid issue.

 

[addo]

As far as we were told in our endocrine course, whether you get hypothyroid or hyperthyroid from a big dose of iodine is idiosyncratic (Wolff-Chaikoff effect or Jod-Basedow effect, respectively). Probably the most you should know is to check the patient's med list very carefully any time they come in with something looking like a thyroid issue.

Im not sure if they are completely idiosyncratic effects... Youre not going to get more hyperthyroid, if you already are, from consuming iodine, like wise youre not going to become more hypothyroid from consuming iodine. Actually, I thought whatever effect you got depended on your thyroid/TSH status... for example, before PTU and methimazole if you came in with hyperthyroidism they would give you KI taking advantage of the wolff-chaikoff effect in this case.