Cited by 146Thyroid Disorders and TreatmentsThyroid Cancer Diagnosis and TreatmentThyroid and Parathyroid Surgery

Drugs affecting thyroid function

Barbesino, Giuseppe·2010·Thyroid

Abstract

INTRODUCTION: Over the years, several drugs used in the treatment of nonthyroidal conditions have been shown to affect thyroid function. As novel drugs are introduced, novel interactions are described. The aim of this review is to summarize clinically relevant thyroidal side effects of drugs used for nonthyroidal conditions. Special focus is given to recent developments and to drugs with the largest clinical relevance. SUMMARY: Thyrosine kinase inhibitors are novel drugs used in the treatment of several neoplasias, including thyroid cancer. Thyroidal side effects are being increasingly detected with these drugs. Some drugs in this category affect thyroid hormone metabolism and therefore only affect patients on thyroid replacement. Others affect the thyroid directly profoundly, causing primary hypothyroidism. Immune modulators used in infectious, inflammatory, and neoplastic conditions also cause hyper- and hypothyroidism, through poorly understood immune or nonimmune mechanisms. The effects of amiodarone on the thyroid have been long recognized. However, given the complexity of these effects, several areas in this field remain problematic, such as the identification of subtypes of hyperthyroidism and the best treatment strategies. Lithium also has important antithyroid effects and it is a commonly prescribed medication. Its antithyroid effects may have clinical utility in selected clinical situations. Other drugs known to affect thyroid hormone absorption, metabolism, and transport are also briefly reviewed. CONCLUSIONS: Several drugs are known to alter thyroid function as a side effect of their primary pharmacological action. Some of these effects have been recognized for decades, but novel thyroid-drug interactions are being recognized as new drugs are developed. It is important for the clinician to be familiar with thyroid-drug interactions, as enhanced surveillance may be necessary in patients undergoing therapies known to affect thyroid function.

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Crossref · 10.1089/thy.2010.1635

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  • Antipsychotic dopamine antagonists, antidepressive tricyclics and α-methyldopa slightly increase serum TSH without altering thyroid function.

    “The antipsycotic dopamine antagonists (e.g., phenothiazines, haloperidol, domperidone, metoclopramide, cimetidine), antidepressive tricyclics and α-methyldopa slightly increase serum TSH without altering thyroid function (17).”

    From L-T4 therapy in the presence of pharmacological interferents (2020) · cites this paper as [17]

  • Patients taking lithium for bipolar disorder are at a high risk of developing thyroid dysfunction, including both hypothyroidism and to a lesser extent thyrotoxicosis.

    “Patients taking lithium for bipolar disorder are at a high risk of developing thyroid dysfunction, including both hypothyroidism and to a lesser extent thyrotoxicosis (652).”

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Authors
Barbesino, G.
Affiliations
Harvard University (US)
Corresponding author
Barbesino, Giuseppe
Venue
Thyroid
Published
2010-07
Volume
20
Issue
7
Pages
763-770
ISSN
  • 1050-7256 (ISSN-L)
  • 1557-9077
OpenAlex
W2106360167
Cited by
146
References
69
Citations by year
2026: 3 · 2025: 4 · 2024: 5 · 2023: 4 · 2022: 7 · 2021: 6 · 2020: 7 · 2019: 8 · 2018: 8 · 2017: 7 · 2016: 12 · 2015: 11 · 2014: 15 · 2013: 14 · 2012: 18
FWCI
11.83
Type
journal article
Language
en
Open access
closed
Locations
  • Thyroid (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
drug-induced thyroid dysfunction, thyroid cancer, primary hypothyroidism, hyperthyroidism, amiodarone, lithium, immunomodulators, thyroid hormone metabolism, thyroid hormone replacement
MeSH terms
Amiodarone, Animals, Anti-Arrhythmia Agents, Drug Interactions, Humans, Lithium, Protein-Tyrosine Kinases, Thyroid Diseases, Thyroid Gland, Antipsychotic Agents, Drug Monitoring, Hormone Replacement Therapy, Protein Kinase Inhibitors, Immunomodulation, Drug-Related Side Effects and Adverse Reactions

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