**2. Amiodarone-induced osteoporosis**

Due to its high iodine content and direct harmful effect on the thyroid gland, amiodarone is however linked to a range of side effects, including thyroid dysfunction (both hypo- and hyper-thyroidism).

A strong antiarrhythmic medication called amiodarone is used to treat supraventricular and ventricular tachyarrhythmias. It is an iodine-rich molecule produced from benzofurans that resemble thyroxine structurally in several ways (T4). Iodine makes up roughly 37% of the weight of amiodarone. It is believed that each 200-mg tablet contains 75 mg of organic iodide, of which 8–17% is released as free iodide. Standard maintenance therapy uses 200 mg of amiodarone, which is 100 times the recommended daily intake [1, 2].

Up to 14–18% of patients undergoing long-term amiodarone therapy develop thyroid problems which range from aberrant results from thyroid function tests to overt thyroid dysfunction, which could be one of the following: 1- Amiodarone-induced thyrotoxicosis (AIT) or 2- Amiodarone-induced hypothyroidism (AIH) [3, 4]. Both can appear in thyroid glands that appear to be normal or in glands that already have abnormalities.
