Breakfast Habits in Patients Using Levothyroxine: Patient Experiences and Preferences

Area of Science:

• Endocrinology
• Pharmacology
• Patient-Reported Outcomes

Background:

• Levothyroxine (LT4) is typically prescribed for hypothyroidism.
• Fasting administration (30-60 minutes before breakfast) is recommended to optimize absorption and avoid drug/food interactions.
• Clinical observations suggest patient adherence to fasting instructions is challenging.

Purpose of the Study:

• To investigate patient experiences with the recommended fasting administration of levothyroxine (LT4).
• To identify patient preferences regarding LT4 intake timing.
• To explore factors associated with nonadherence to fasting LT4 instructions.

Main Methods:

• A questionnaire was distributed to patients using LT4.
• Regression analyses were employed to identify predictors of nonfasting intake, burden, and preference.
• Data collected included adherence rates, reasons for nonadherence, and patient preferences.

Main Results:

• High nonadherence (69.7%) to fasting LT4 instructions was observed, despite 97.3% receiving them.
• Nonfasting intake was linked to co-medication use, longer treatment duration, and male sex.
• Half of patients felt burdened by postponing breakfast; 60.5% preferred nonfasting intake, with some omitting meals or forgetting medication.

Conclusions:

• The current fasting recommendation for LT4 presents a significant burden, leading to widespread nonadherence and irregular dosing.
• Patient preference strongly favors nonfasting LT4 ingestion.
• Further research into alternative, non-fasting administration strategies for levothyroxine is essential to improve patient compliance and therapeutic outcomes.