Video Experimental Relacionado

Updated: Jan 8, 2026

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

Published on: September 20, 2019

Levothyroxine (LT4) con desayuno frente a la ingestión en ayunas, con ajuste de dosis, en el hipotiroidismo: un

Jeresa I A Willems¹, Daan J L van Twist¹, Floris Helmich²

¹Department of Internal Medicine, Zuyd Thyroid Center, Zuyderland Medical Center, Sittard/Heerlen, the Netherlands.

The Journal of clinical endocrinology and metabolism

|December 23, 2025

Resumen

Tomar levotironina (LT4) con el desayuno, con un aumento de dosis del 15 %, mantuvo la estabilidad de la hormona estimulante de la tiroides (TSH) y mejoró el bienestar del paciente. Este enfoque centrado en el paciente ofrece una alternativa viable a la ingesta de LT4 en ayunas.

Sus antecedentes:

La levotiroxina (LT4) se toma normalmente con el estómago vacío para maximizar la absorción.
La ingesta en ayunas puede ser inconveniente y puede disminuir la adherencia del paciente al tratamiento.
Los estudios de preferencias de los pacientes indican un deseo significativo de administración de LT4 sin ayuno.

Objetivo del estudio:

Evaluar la eficacia de la ingesta de LT4 sin ayuno, con un ajuste de dosis del 15 %, en el mantenimiento de la estabilidad de la hormona estimulante de la tiroides (TSH).
Comparar la estabilidad de la TSH entre los pacientes que toman LT4 con el desayuno y los que la toman en ayunas.
Evaluar el bienestar del paciente y la preferencia de tratamiento en ambos grupos de estudio.

Principales métodos:

Un ensayo controlado aleatorizado en adultos con hipotiroidismo bien controlado.
Los participantes fueron asignados a la ingesta de LT4 en ayunas o a la ingesta de LT4 con desayuno ajustado en dosis.
Se monitorizaron los niveles de hormona tiroidea (TSH, FT4, TT3), con ajustes de dosis según fuera necesario, para lograr la estabilidad de la TSH.

Principales resultados:

La estabilidad de la TSH fue comparable entre los grupos en ayunas (74,4 %) y con desayuno (73,3 %).
Los pacientes que tomaron LT4 con el desayuno informaron de un mejor bienestar y una preferencia significativamente mayor por la ingesta sin ayuno (76,2 %).
Un alto porcentaje (88,9 %) de los pacientes optó por continuar la ingesta de LT4 sin ayuno después del estudio.

Conclusiones:

La administración de levotiroxina con el desayuno, junto con un aumento de dosis del 15 %, mantiene eficazmente la estabilidad de la TSH.
Este enfoque sin ayuno mejora el bienestar y la adherencia del paciente, alineándose con las preferencias del paciente.
La ingesta de LT4 sin ayuno representa una alternativa práctica y centrada en el paciente a la administración tradicional en ayunas.

Palabras clave:

desayuno ingesta en ayunas hipotiroidismo levotiroxina

Más Videos Relacionados

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

Published on: May 12, 2023

Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model

Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model

Published on: March 17, 2023

Videos de Conceptos Relacionados

Bioavailability Study Design: Healthy Subjects Versus Patients

Bioavailability Study Design: Healthy Subjects Versus Patients

Bioavailability studies are essential for evaluating a drug's therapeutic efficacy and understanding its absorption patterns under various physiological conditions. Conducting such studies on target patient populations provides more relevant data by simulating real-world disease states. However, practical challenges often necessitate the use of young, healthy adult volunteers as study subjects.Patients may exhibit altered drug absorption patterns due to the effects of the disease itself,...

Bioavailability Study Design: Single Versus Multiple Dose Studies

Bioavailability Study Design: Single Versus Multiple Dose Studies

Bioavailability studies are essential for understanding how a drug is absorbed, distributed, metabolized, and excreted in the body. These studies assess the extent and rate at which the active pharmaceutical agent becomes available at the site of action. The design of bioavailability studies can involve single-dose or multiple-dose regimens, each with distinct advantages and limitations.Single-dose studies are the preferred approach due to their simplicity and reduced drug exposure for...

Bioavailability Study Design: Absolute Versus Relative Bioavailability

Bioavailability Study Design: Absolute Versus Relative Bioavailability

Bioavailability is a crucial pharmacokinetic parameter that quantifies the proportion of an administered drug that reaches the systemic circulation and is available for therapeutic action. Regulatory agencies mandate the assessment of bioavailability, typically measured as the area under the drug plasma concentration-versus-time curve (AUC), to ensure the efficacy and safety of pharmaceutical products. These evaluations are categorized as absolute and relative bioavailability studies.Absolute...

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...

Synthesis and Regulation of Thyroid Hormones

Synthesis and Regulation of Thyroid Hormones

Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...

Drug Dosing: Obese Patients

Drug Dosing: Obese Patients

In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...