Iatrogenicity is inherent to endocrinology, being a consequence of treatment
(e.g., use of thyroid hormones in large doses to suppress thyroid stimulating hormone
[TSH] in thyroid cancer) or occurring due to a lack of patient compliance (e.g., lack of
adequate controls in chronic diseases, such as Hashimoto’s chronic thyroiditis). Quite
often, it is induced as a side effect of medicines (e.g., long-lasting use of antithyroid
agents or glucocorticoids). In this chapter, we review the most important iatrogenic
effects, according to the main features of endocrinology. We present certain drugs that
can trigger particular syndromes, such as the syndrome of inappropriate antidiuretic
hormone secretion (SIAHS), along with preparations with pitressin and complications
of treatment performed for pituitary adenomas, potential complications of drugs used to
treat pituitary insufficiency in children and other specific features constituting required
knowledge for medical practitioners. All therapeutic modalities of hyperthyroidism
(medical, surgical, radioiodine) can cause iatrogenic pathology. For example, the
euthyroid state is a sine qua non condition of thyroid surgery (except the thyrotoxic
storm in advanced stages). Radioiodine treatment, in turn, has its own
contraindications. Iodine-containing preparations can activate thyroid autonomies and
aggravate autoimmune thyroiditis and overt hyperthyroidism. In hypothyroid elderly
and cardiac patients, the thyroid hormone substitution must be applied only after initial
cardiovascular treatment, in small, gradually increasing doses. In Addison’s disease,
indication of dietary salt reduction alongside glucocorticoid substitution, or the lack of
increase in glucocorticoid dose in acute injuries, are serious iatrogenic complications.
Keywords: Acromegaly, Adrenal glands, Amiodarone, Antithyroid agents,
Gonads, Hypercalcemia, Hyperthyroidism, Hypothyroidism, Octreotide,
Thyroiditis.
