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Amiodarone thyroid dysfunction — GPhC CRA MCQ

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HardCardiovascular TherapeuticsAmiodarone thyroid dysfunctionGPhC CRA

A 70-year-old woman taking levothyroxine 75micrograms daily is started on amiodarone for AF. Three months later she reports weight loss, tremor and palpitations. TSH is suppressed and free T4 is raised. What monitoring is required?

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Correct answer: B — Thyroid function monitoring and prescriber review because amiodarone can cause thyroid dysfunction

Amiodarone contains iodine and can cause both hypothyroidism and hyperthyroidism. Symptoms plus suppressed TSH and raised free T4 suggest thyrotoxicosis requiring prescriber or specialist review. Thyroid function should be checked before and during treatment. INR may be relevant if on warfarin, but it does not address the thyroid abnormality.

Reference: BNF; NICE CKS Hyperthyroidism