Oral L-thyroxine liquid versus tablet in patients with hypothyroidism without malabsorption: a prospective study
Open accessAbstract
No consistent data are present in literature about the effectiveness of levothyroxine (L-T4) liquid formulation in patients without malabsorption. The aim of this study is to compare the effectiveness of L-T4 liquid formulation, with L-T4 tablets, in hypothyroid patients without malabsorption or drug interference. One hundred and fifty two patients were recruited. Patients were switched from the L-T4 therapy in tablets, to liquid L-T4 at the same dosage, 30 min before breakfast. Serum thyrotropic hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were re-evaluated after 1-3 months (first control) and 5-7 months (second control) from the switch. TSH values significantly declined with respect to the basal value after the switch to liquid L-T4 both at the first control (P < 0.05) and at the second control (P < 0.01); FT4 and FT3 levels were not significantly changed. We show that liquid L-T4 is more effective than L-T4 tablet in controlling TSH levels in hypothyroid patients without malabsorption, gastric disorders, or drug interference.
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Following the switch to the liquid formulation, TSH levels among patients significantly declined compared to the basal value at both the first control (P < 0.05) and the second control (P < 0.01).
“Following the switch to the liquid formulation, TSH levels among patients significantly declined compared to the basal value at both the first control (P < 0.05) and the second control (P < 0.01).”
From Diagnosis and management of treatment-refractory hypothyroidism: an expert consensus report (2017) · cites this paper as [123]
Levels of both FT4 and FT3 were not significantly changed after switching to the liquid formulation.
“Levels of both FT4 and FT3 were not significantly changed [123].”
From Diagnosis and management of treatment-refractory hypothyroidism: an expert consensus report (2017) · cites this paper as [123]
Orally administered liquid and soft-gel LT4 formulations are associated with higher serum FT4 levels and lower TSH levels than tablet formulations, even when the overall LT4 dose level is the same.
“Other reports from both retrospective and prospective observational studies indicate that orally administered liquid and soft-gel formulations of LT4 are associated with higher serum FT4 levels and lower TSH levels than tablet formulations, even when the overall LT4 dose level is the same – perhaps due to the absence of gastric disintegration [ 38 – 44 ].”
From Factors influencing the levothyroxine dose in the hormone replacement therapy of primary hypothyroidism in adults (2022) · cites this paper as [40]
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- Authors
- Fallahi, P., Ferrari, S. M., & Antonelli, A.
- Affiliations
- University of Pisa (IT)
- Corresponding author
- Antonelli, Alessandro
- Venue
- Endocrine
- Published
- 2015-12-31
- Volume
- 52
- Issue
- 3
- Pages
- 597-601
- ISSN
- 0969-711X (ISSN-L)
- 1355-008X
- 1559-0100
- OpenAlex
- W2206282986
- Cited by
- 53
- References
- 34
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 7 · 2020: 4 · 2019: 6 · 2018: 5 · 2017: 7 · 2016: 10
- FWCI
- 6.38
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- www.springer.com/tdm (tdm)
- Locations
- Endocrine (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- levothyroxine, hypothyroidism, TSH response, free thyroxine, free triiodothyronine, thyroid hormone replacement, drug absorption
- MeSH terms
- Administration, Oral, Adult, Aged, Drug Administration Schedule, Drug Compounding, Female, Humans, Hypothyroidism, Malabsorption Syndromes, Male, Middle Aged, Solutions, Tablets, Thyrotropin, Thyroxine, Triiodothyronine, Treatment Outcome, Hormone Replacement Therapy
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