Early Diagnosis and Optimization of the Management of Amiodarone-Induced Thyroid Dysfunction in the Aral Sea Region

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.