Abstract:
Amiodarone-induced thyroid dysfunction (AITD) is a clinically significant complication, particularly in environmentally
high-risk regions such as the Aral Sea area, where iodine deficiency and environmental pollution prevail. This study aimed to
develop and validate an algorithm for early diagnosis and optimized management of AITD. A total of 98 patients receiving
amiodarone therapy for cardiac arrhythmias were prospectively observed from 2022 to 2024. Thyroid dysfunction was
classified as overt or subclinical hypothyroidism, overt or subclinical thyrotoxicosis, or euthyroid hyperthyroxinemia.
Hormonal (TSH, free T4, free T3, TRAb, anti-TPO, anti-TG), biochemical, electrocardiographic, Holter, and
echocardiographic parameters were assessed. Individualized therapy for hypothyroidism (L-thyroxine) and thyrotoxicosis
(antithyroid drugs or glucocorticoids) was applied. The proposed algorithm enables early detection of AITD, optimization of
therapy, prevention of complications, and improvement of patient outcomes in iodine-deficient regions.
