OBJECTIVE: To present information regarding the potential danger of performing levothyroxine withdrawal radioiodine scans and treatment in patients with thyroid cancer who are concurrently taking lipid-lowering agents. METHODS: We review the clinical history, serial laboratory data, and radiologic findings in 2 patients with multifocal papillary carcinoma of the thyroid. RESULTS: Both study patients had substantial elevations of muscle enzymes or myopathies (or both) when they were withdrawn from levothyroxine therapy, during treatment with lipid-lowering agents, in preparation for radioiodine scanning and treatment. CONCLUSION: Extreme caution should be exercised when levothyroxine therapy is withdrawn from patients taking lipid-lowering agents. Such patients should be monitored very closely or, when appropriate, recombinant human thyroid-stimulating hormone injections should be used rather than levothyroxine withdrawal in this setting.
OBJECTIVE: To present information regarding the potential danger of performing levothyroxine withdrawal radioiodine scans and treatment in patients with thyroid cancer who are concurrently taking lipid-lowering agents. METHODS: We review the clinical history, serial laboratory data, and radiologic findings in 2 patients with multifocal papillary carcinoma of the thyroid. RESULTS: Both study patients had substantial elevations of muscle enzymes or myopathies (or both) when they were withdrawn from levothyroxine therapy, during treatment with lipid-lowering agents, in preparation for radioiodine scanning and treatment. CONCLUSION: Extreme caution should be exercised when levothyroxine therapy is withdrawn from patients taking lipid-lowering agents. Such patients should be monitored very closely or, when appropriate, recombinant human thyroid-stimulating hormone injections should be used rather than levothyroxine withdrawal in this setting.
Authors: Maciej Banach; Manfredi Rizzo; Peter P Toth; Michel Farnier; Michael H Davidson; Khalid Al-Rasadi; Wilbert S Aronow; Vasilis Athyros; Dragan M Djuric; Marat V Ezhov; Robert S Greenfield; G Kees Hovingh; Karam Kostner; Corina Serban; Daniel Lighezan; Zlatko Fras; Patrick M Moriarty; Paul Muntner; Assen Goudev; Richard Ceska; Stephen J Nicholls; Marlena Broncel; Dragana Nikolic; Daniel Pella; Raman Puri; Jacek Rysz; Nathan D Wong; Laszlo Bajnok; Steven R Jones; Kausik K Ray; Dimitri P Mikhailidis Journal: Arch Med Sci Date: 2015-03-14 Impact factor: 3.318