In short Article

Influence of drugs on thyroid values

Thyroid and drugs Part 1


The first of a series of three articles on the influence of drugs on the thyroid gland discusses the influence that drugs can have on the findings of laboratory assessments of thyroid values. It particularly focuses on the question whether this could lead to incorrect diagnoses and unjustified treatment. Is it possible that a lab finding suggests a thyroid disorder whereas there is no actual disorder present? Many drugs are known to influence the values of the thyroid hormones (T4 and T3), but effects on the value of thyroid stimulating hormone (TSH) are rare. Since TSH assessment is the cornerstone of diagnostic workup when a thyroid disorder is suspected, a disorder can be virtually excluded if the TSH value is within normal limits. Only amiodarone and biotin are known to be able to affect TSH values. This can lead to confusion in interpreting a lab finding. 

  • Various drugs are known to affect the values of T3 and T4. Drugs rarely cause abnormal TSH findings.
  • The use of amiodarone or biotin (vitamin B8) can result in abnormal TSH values in  the absence of disturbed thyroid function.
  • In view of possibly abnormal TSH values, it is important for doctors to be aware of a patient’s drug use, including the use of over-the-counter drugs that might affect the diagnostics.
  • Biotin is a dietary supplement that is freely available and is hence usually not listed on an overview of drugs used by a patient. 

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Authors

  • Suzanne de Klerk
  • Gideon Lansbergen
  • Thiemo F. Veneman
  • Sander D. Borgsteede