29
Figure 1. A Suggested Approach to the Management of AIT
Patient taking amiodarone
MMI + GC
Hypothyroid
evaluation
Normal
a
Based on clinical history, TRAb, Doppler flow, ultrasound ± RAIU
Serum
TSH
Low
High
Euthyroid
Observe
Free T
4
or T
3
Elevated
TSH
<0.1 mU/L
TSH
0.1–0.4 mU/L
TMNG,
AFTN, Graves'
disease
Monitor
Cardiovascular
Compromise
Cardiovascular
Stability
MMI alone GC alone
Attempt
MMI Taper
Continue
MMI + GC
Continue
GC
Add MMI
Clinical Improvement
Continue
therapy
Consider
Thyroidectomy
Rapid
Improvement
Rapid
Improvement
NO
YES
NO
YES
NO YES
NO
YES
NO
YES
NO
YES
