About Iatrogenic Hypothyroidism

Iatrogenic Hypothyroidism

The word “iastros” is an ancient term for ‘healer’ – Socrates for example was an ‘iastros tes psuches’ or ‘healer of the soul’.  “Genic” means ‘produced or caused by‘.  When you put these two words together you get ‘iatrogenic’ which literally means ‘healer caused or produced’.   Today it commonly refers to medical conditions or complications that have been brought on by treatments or advice given by members of the medical profession.  In the case of iatrogenic hypothyroidism, it means an under active thyroid condition that has been caused by some form of medical treatment or medical advice.  Iatrogenic hypothyroidism can be either permanent or reversible, depending on what has caused it and the extent of the damage done to the thyroid gland.

Iatrogenic Hypothyroidism – Common Causes

Drug (medication) induced hypothyroidism – as the name indicates, this form of iatrogenic hypothyroidism is caused by drugs or medication treatments that have been administered to a patient.  Some drugs used to treat hyperthyroidism, a condition in which the thyroid produces too much hormone, can cause hypothyroidism.  Amongst them are drugs like potassium iodide,  propylthiouracil and methimazole.

Other non-thyroid drugs used in treating other disorders can also cause drug-induced iatrogenic hypothyroidism. These include interleukin, lithium, amiodarone, sulfonylureas, nitroprusside, perchlorate, thalidomide and interferon-alpha therapy.

Iodine based topical antiseptics like povidone-iodine, better known as Betadine, can cause iatrogenic thyroid problems if enough of the iodine is absorbed by the body.  Transient congential hypothyroidism is a case in point – povidone-iodine solutions are commonly used either during the birthing process, for treating the umbilical stump and for disinfecting the skin prior to treatment (injections or surgery).  If the infant absorbs enough of the iodine it can temporarily interfere with their thyroid function.  There are also documented cases of topical iodine medications causing iatrogenic hypothyroidism in patients being treated for other health issues.

Many cases of drug and medication induced iatrogenic hypothyroidism are reversible as the drugs / medications only interfere with the thyroid’s ability to produce thyroid hormones.  Once these treatments  are discontinued thyroid function often returns to normal.

Surgically induced (post-operative) hypothyroidism – this is often listed as one of the more common non-disease related causes of iatrogenic hypothyroidism.  Surgical treatment (thyroidectomy) for conditions like thyroid cancer, thyroid nodules or Graves’ disease removes either part of the thyroid gland or all of it depending on the extent of the problem.  Iatrogenic hypothyroidism always happens in cases where it is necessary to remove the entire thyroid gland.  If only part of it is removed the thyroid may still retain enough functionality to continue producing sufficient hormone to maintain normal blood levels.  Quite often though it’s the case that the patient is left with impaired thyroid function necessitating life-long thyroid replacement therapy.

Radiation induced hypothyroidism – radioactive iodine may be used as an alternative to surgery to treat Graves’ disease, thyroid cancer or thyroid nodules.  This destroys the thyroid gland, resulting in permanent iatrogenic hypothyroidism.  Other types of upper body cancers and Hodgkin’s disease are treated with radiation therapy, which may result in impaired, or complete loss of, thyroid function.  Again, the result is permanent iatrogenic hypothyroidism.

Iatrogenic Hypothyroidism Symptoms

Regardless of cause, hypothyroidism is hypothyroidism.  It’s caused by insufficient thyroid hormone production.  Therefore, the symptoms of iatrogenic hypothyroidism are identical to those for all other types of hypothyroidism.

Iatrogenic Hypothyroidism Treatment

Many cases of drug induced hypothyroidism will treat themselves once/if the medications and drugs causing the condition are stopped.  It may take a few months however, and during this time the patient may need to be on temporary hormone replacement therapy.  Irreversible iatrogenic hypothyroidism will require the same life-long treatment and life-style management as any other permanent type of hypothyroidism.

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