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Conditions and drugs interfering with thyroxine absorption.

Llanyee Liwanpo1, Jerome M Hershman

  • 1Department of Endocrinology, VA Greater Los Angeles Healthcare System, Endocrinology 111D, 11301 Wilshire Blvd, Los Angeles, CA 90073, USA. liwanpol@cshs.org

Best Practice & Research. Clinical Endocrinology & Metabolism
|November 28, 2009
PubMed
Summary

Certain foods, like coffee and fiber, and conditions such as celiac disease can reduce levothyroxine absorption. Many common medications also impact how well this thyroid hormone is absorbed.

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Area of Science:

  • Endocrinology
  • Gastroenterology
  • Pharmacology

Background:

  • Levothyroxine is a critical medication for thyroid hormone replacement therapy.
  • Proper absorption of levothyroxine is essential for its therapeutic efficacy.
  • Several factors are known to influence levothyroxine absorption, impacting treatment outcomes.

Purpose of the Study:

  • To identify and summarize common dietary components and medical conditions that interfere with levothyroxine absorption.
  • To list frequently used medications that may affect the bioavailability of levothyroxine.
  • To inform healthcare providers and patients about potential absorption challenges with levothyroxine therapy.

Main Methods:

  • Literature review of studies investigating factors affecting levothyroxine absorption.
  • Analysis of reported interactions between levothyroxine and various foods, disorders, and drugs.
  • Synthesis of findings on malabsorptive conditions and drug-induced interference.

Main Results:

  • Dietary factors including food, dietary fiber, and espresso coffee were found to interfere with levothyroxine absorption.
  • Malabsorptive disorders such as celiac disease, inflammatory bowel disease, lactose intolerance, Helicobacter pylori infection, and atrophic gastritis negatively affect levothyroxine absorption.
  • Commonly prescribed drugs including bile acid sequestrants, ferrous sulfate, sucralfate, calcium carbonate, antacids, phosphate binders, raloxifene, and proton-pump inhibitors can inhibit levothyroxine absorption.

Conclusions:

  • Levothyroxine absorption is significantly impacted by various dietary elements, gastrointestinal disorders, and a wide range of medications.
  • Awareness of these interfering factors is crucial for optimizing levothyroxine therapy and managing thyroid conditions effectively.
  • Patients taking levothyroxine should be advised about potential interactions to ensure adequate hormone levels.