High dose hypothyroid medications increase stroke risk

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New study shows too much hypothyroid medication can lead to heart rhythm disorder and stroke

High doses of hypothyroidism medication could increase the risk of stroke, a new study has found.

The study looked at 174,000 patients. It found that being treated with too much hypothyroid medication can lead to an increased risk of atrial fibrillation, a common heart rhythm disorder associated with stroke.

“Thyroid hormones are associated with losing weight and having more energy, which may lead to people being treated at the high end of the normal range”

The findings were presented by researchers from the Intermountain Medical Center Heart Institute in Salt Lake City at the American Heart Association Scientific Session conference in Chicago.

“We know patients with hypothyroidism have a higher risk of atrial fibrillation, but we didn’t consider increased risk within what’s considered the normal range of thyroid hormones,” said lead researcher Jeffrey L. Anderson, MD, Distinguished Clinical and Research Physician at the Intermountain Medical Center Heart Institute, which is part of the Intermountain Healthcare system. “These findings show we might want to re-consider what we call normal.”

In the new study, researchers surveyed the electronic medical records of 174,914 patients treated at Intermountain Healthcare facilities whose free thyroxine (fT4) levels were recorded and who were not on thyroid replacement medication. Researchers then took what’s considered a normal range of fT4 levels, divided it into four quartiles, then looked at those patients’ records for a current or future diagnosis of atrial fibrillation.

They found a 40 percent increase in existing atrial fibrillation for patients in the highest quartile of fT4 levels compared to patients in the lowest, and a 16 percent increase in newly developing atrial fibrillation during 3-years of follow up.

These findings, said Dr. Anderson, suggest that the optimal healthy range of fT4 should be reconsidered and redefined.

“Thyroid hormones are associated with losing weight and having more energy, which may lead to people being treated at the high end of the normal range,” said Dr. Anderson. “Are we harming people by putting them at a higher risk of atrial fibrillation, and therefore stroke?”

The study also showed that fT4 should be measured, along with thyroid-stimulating hormone (TSH), which is more commonly tested for in patients with irregular thyroid hormone levels but was not helpful within the normal range in refining risk.