Evidence for Interference With the Intestinal Absorption of Levothyroxine Sodium by Aluminum Hydroxide
Abstract
A patient with hypothyroidism who was euthyroid on a fixed-dosage, long-term maintenance regimen of levothyroxine sodium developed persistently elevated serum thyrotropin levels while receiving an aluminum hydroxide-containing antacid. The thyrotropin levels returned to normal shortly after cessation of the antacid therapy. These observations indicate that aluminum hydroxide may interfere with the bioavailability of thyroxine. The thyroid function of patients who are receiving replacement or suppressive thyroxine therapy should be monitored following the commencement of concurrent treatment with medications containing aluminum hydroxide.
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Following documentation of increased LT4 requirement in a patient taking an aluminum-containing antacid (142), the same investigators showed an increase in TSH levels in five patients who were asked to take aluminum hydroxide with their LT4 (143).
“Following documentation of increased LT4 requirement in a patient taking an aluminum-containing antacid (142), the same investigators showed an increase in TSH levels in five patients who were asked to take aluminum hydroxide with their LT4 (143).”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [142]
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- Authors
- Sperber, A. D.
- Affiliations
- Soroka Medical Center (IL)
- Corresponding author
- Sperber, Ami D.
- ORCID
- Sperber, Ami D.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 1992-01-01
- Volume
- 152
- Issue
- 1
- Pages
- 183
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W1973997753
- Cited by
- 66
- References
- 12
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 3 · 2015: 2 · 2014: 3 · 2013: 1 · 2012: 1
- FWCI
- 1.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Keywords
- levothyroxine sodium, aluminum hydroxide, antacids, drug interactions, intestinal absorption, bioavailability, thyroid-stimulating hormone, hypothyroidism, thyroid function monitoring, thyroid hormone replacement
- MeSH terms
- Aluminum Hydroxide, Biological Availability, Humans, Hypothyroidism, Intestinal Absorption, Male, Middle Aged, Thyroxine
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