Thyroid hormone adverse reaction

Lactation Minimal amounts of thyroid hormones are excreted in breast milk. Thyroid is not associated with serious adverse reactions. 

Observational studies In an open study of the use of atomoxetine in 20 adults with ADHD, aged 19-47 years, for 10 weeks initially and 1 year in responders, adverse events that were reported in more than 5% of patients were dry mouth, fatigue, sweating, erectile dysfunction, insomnia, reduced appetite, restlessness, low mood, constipation, urine retention, weight loss, vertigo, irritability, emotional lability, and headache [50 ]. Six patients discontinued before 10 weeks and 13 at 10 weeks or later, mainly because of adverse reactions (aggression, low mood, and altered liver enzymes, thyroid hormones, or diastolic blood pressure). 

Uses Thyroid hormones, levothyroxine (T4), and triiodothyronine (liothyronine, T3) are used to treat hypothyroidism. Both overt and subclinical hypothyroidism are associated with dyslipidemia, and replacement with thyroid hormones lowers the concentrations of serum low-density lipoprotein (LDL) cholesterol and has other potentially favorable actions on lipoprotein metabolism [1 ]. Consequently, thyro-mimetic drugs, which mimic the actions of thyroid hormones, hold promise as lipidlowering agents. The development of some of these drugs was discontinued because of adverse reactions related to thyroid hormone-like actions, including possible death due to cardiac causes and adverse effects on bone [2 , 3 ]. 

Topical methimazole is used as a skin depigmenting agent for conditions that include epidermal melasma. In 20 patients who used this treatment once daily for 6 weeks there were no significant changes in circulating thyroid hormone or thyroid-stimulating hormone (TSH) and no significant cutaneous adverse reactions [33 ]. 

Accepting their well-known side effects the benzothiadiazine derivatives remain a mainstay in the treatment with diuretics, especially in hypertension. The need for caution before prescribing antihypertensive diuretics to patients with myxoedema is indicated by a case reported by Takeda of an adverse reaction to trichlormethiazide (17 -). In this myxoedemic patient, sinus arrest occurred during treatment with the drug. Renewed treatment with the diuretic after substitution with thyroid hormone was possible without complications. 

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