—Dr Jonckheer points out that an important geographic consideration exists in a patient's response to the administration of an iodinated compound, such as amiodarone. A recent article by Fradkin and Wolff1 emphasizes that the occurrence of iodide-induced thyrotoxicosis is dependent not only on the functional status of the thyroid gland but also on the dietary supplement of iodine. Hyperthyroidism induced by exposure to iodine-containing agents occurs more often in Europe (where the diet is low in iodine) than in North America. On the other hand, several cases of iodide-induced thyrotoxicosis following the ingestion of amiodarone, which were reviewed by Fradkin and Wolff,1 were found to occur when urinary excretion of iodide was low. This suggests that amiodarone indeed has complex effects.
Amico JA, Klein I. Amiodarone Therapy and Hyperthyroidism in Europe-Reply. Arch Intern Med. 1984;144(12):2429–2430. doi:10.1001/archinte.1984.00350220165039
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