27
Table 13. Causes of Drug-Associated Thyrotoxicosis
Drug Mechanism(s)
Timing of
onset following
initiation of the
drug Therapy
Amiodarone Iodine induced
(type 1)
Months to Years
Supportive care
a
ATDs; perchlorate
b
Surgery
yroiditis (type 2) Oen >1 year
Supportive care
a
Corticosteroids
Surgery
Lithium Painless thyroiditis Oen >1 year
Supportive care
a
GD ATDs and/or RAI
(GD only)
Interferon α Painless thyroiditis Months
Supportive care
a
GD ATDs and/or RAI
(GD only)
Interleukin-2 Painless thyroiditis Months
Supportive care
a
GD ATDs and/or RAI
(GD only)
Iodinated contrast Underlying thyroid
autonomy
Weeks to months Antithyroid drugs
Tyrosine kinase
inhibitors
Destruction 3–12 months Supportive care
Radioactive iodine,
early
Destruction 1–4 weeks Observation; if
severe, administer
corticosteroids
Radioactive iodine
for TMNG, late
GD 3–6 months Antithyroid drugs
Repeat RAI
Surgery
Thyroid hormone ingestion (levothyroxine (T
4
), liothyronine (T
3
), thyroid extract, and
non-prescription supplements that contain thyroid hormone may cause thyrotoxicosis
factitia (see Table 14).
a
Supportive care may include beta-adrenergic blockers during the thyrotoxic stage and
levothyroxine if hypothyroidism develops.
b
Not available in the United States.
Drug-Associated Thyrotoxicosis
Other Conditions
