Amiodarone Hypothyroidism

Amiodarone has been effective in keeping me in NSR but a recent deep dive uncovered some serious effects that Amiodarone has on my other health problem; hypothyroidism. I suspect that Amiodarone has significantly increased my reverse T3 way above normal leaving me with all the symptoms of hypothyroidism despite a normal free T3 lab result. Anyone know anything about this?

The anti-arrhythmic dronedarone was supposedly developed to avoid some of the problems present with amiodarone, has anyone switched to dronedarone from amiodarone?

That is one dangerous med for many and Hypothyroidism isnt your only worry. Im surprised Cardios still prescribe that med. May be time to change Cardios.

You might want to have a look at this article. In particular, scroll down to the section labeled "MANAGEMENT OF THYROTOXICOSIS WHEN AMIODARONE CAN BE STOPPED." Although switching to another antiarrhythmic is something I would do ASAP if I were you, it's going to take months to clear from your system and it might not help the hypothyroidism anyway. I'd still go ahead and stop it, though, because long-term use of amiodarone can cause a lot more serious problems than thyroid issues.

Welcome Hwkmn05

When did you start AMIO and how old are you now? What was the reason your cardio or EP gave you for starting you on such a powerful AAR drug. AMIO should typically be used only in rare cases when there is no other way to control an intractable arrhythmia and even then typically for as short a time as possible.

An exception some cardios and some clinical EPs will use AMIO for a bit longer period is for very elderly patients who are having on going symptomatic afib or asymptomatic AFIB in the presence of significant Heart failure where the possibility of restoring NSR for an extended period might buy the patient more time. Especially when other co-morbidity might also exist that could make them
less of an ablation candidate.

The crazy thing is you will see some misguided docs even parking people in their 30s on AMIO to control AFIB, I would consider this borderline, or possibly frank, malpractice. I’ve only seen this happen will with generally well-meaning cardios who are so mis-informed about the overall safety and efficacy of an expert ablation process that they consider AMIO the preferred solution for such you g folks! The biggest problem is that these kind of docs not infrequently lose sight of these patients when, for example, they move to another state or city and their new docs in their adopted new town just assume their AMIO use is being closely monitored by another long term physician.

There are 101 different scenarios in which such a young Afibber who has been wrongly shackled to AMIO use, can wind up on daily full strength AMIO for a decade or more! I’ve seen this happen more than a few times and have heard many more similar incredulously-recounted ‘war stories by other top EPs who were stunned and outraged that AMIO would be used so carelessly and inappropriately.

Such unfortunate patients not infrequently wind up suffering from a litany of awful side effects and long term bad consequences as noted above with potential major thyroid dysfunction, pulmonary fibrosis, serious retinal impact including possible blindness and a host of other very unpleasant outcomes from long term use of AMIO. And not the least of which is the possibility of one’s skin turning blue.

That being said, for sure AMIO does have its role in arrhythmia care as the most powerful AAR drug. However, with that power comes the responsibility of any doctor prescribing it to do so with real caution and with very careful patient selection and always with a focus on keeping their patients on it for the least amount of time necessary for their patients individual scenario.

Shannon