TH and hyperthyroidism: Amiodarone affects thyroid physiology through both its high iodine content and direct interference with TH metabolism [18], potentially leading to hypothyroidism or thyrotoxicosis Importantly, in patients with RTHβ—who typically present with elevated TH levels—the main concern is that amiodarone-induced hyperthyroidism or thyrotoxicosis may further increase circulating TH concentrations and cardiovascular risk.