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Aim . Amiodarone, a class III anti-arrhythmic can be a life-saving medication however it can also cause amiodarone-induced thyroiditis (AmIT). Though rare, it is a complex and life-threatening side effect. AmIT can cause significant cardiac dysfunction and lead to cardiac failure. Though generally treated medically, a small sub-group do not respond and their cardiovascular function continues to deteriorate. This select group is referred for a semi-elective total thyroidectomy. Without surgical removal of their thyroid gland these patients will continue to deteriorate, with a 30–50% mortality rate for those not operated on. The aim of this study was to assess for any indicators as to when these patients should be referred for total thyroidectomies and the efficacy of this method of treatment. Method . A case series of patients with amiodarone-induced thyroiditis treated with a total thyroidectomy from 1998–2015 was used to retrospectively assess the efficacy and indicators for surgery. Results . T4 values decreased quickly and significantly after surgery. Patients’ symptoms mostly resolved after surgery. No clear indicators were found to be common throughout the cohort as to how long medical therapy should be pursued. Conclusion . Clinicians should view surgery as an effective and efficient treatment avenue for amiodarone-induced thyrotoxicosis. However, it is not clear when this treatment should be instigated. A case-by-case approach should be adopted when treating these complicated patients.

Efficacy of the surgical management of amiodarone-induced thyroiditis.