Abstract
The high iodine content of amiodarone precludes its use at any dose without at least a magnitude increase in exposure to iodine. A 200 mg tablet contains 75 mg of iodine, or which 7.5 mg is bioavailable, rapidly dwarfing the normal total body content of 14 mg. Hyperthyroidism is observed in about 3.3% of individuals in populations exposed to an increase in environmental iodine through increased salt fortification, water purification or seaweed ingestion. Study of linked prescription/clinical databases confirms that patients taking amiodarone and thus exposed to excess iodine, also experience hyperthyroidism at a rate of 3-4%. This suggests they are reacting to iodine rather than the peripheral pharmacological effect of amiodarone on thyroxine conversion to triiodothyronine. We studied the incidence of hyperthyroidism in patients enrolling in the Calgary Amiodarone Clinic and compared it to personal experience in other Canadian cities.
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