Two cases of statin-induced myopathy caused by induced hypothyroidism

Endocr Pract. 2008 Sep;14(6):726-31. doi: 10.4158/EP.14.6.726.

Abstract

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Results: Both study patients had substantial elevations of muscle enzymes or myopathies (or both) when they were withdrawn from levothyroxine therapy, during treatment with lipid-lowering agents, in preparation for radioiodine scanning and treatment.

Conclusion: Extreme caution should be exercised when levothyroxine therapy is withdrawn from patients taking lipid-lowering agents.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.

Publication types

  • Case Reports

MeSH terms

  • Drug Administration Schedule
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Hypothyroidism / chemically induced*
  • Iodine Radioisotopes / therapeutic use
  • Male
  • Middle Aged
  • Muscular Diseases / chemically induced*
  • Simvastatin / administration & dosage
  • Simvastatin / adverse effects*
  • Thyroid Neoplasms / drug therapy
  • Thyroid Neoplasms / radiotherapy
  • Thyroxine / administration & dosage*
  • Thyroxine / adverse effects
  • Thyroxine / therapeutic use

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Iodine Radioisotopes
  • Simvastatin
  • Thyroxine