Absorption Kinetics of Levothyroxine Is Not Altered by Proton-pump Inhibitor Therapy
Abstract
Introduction Iodothyronines are widely prescribed drugs in developed countries. Several studies have shown a high prevalence of hypothyroidism in unselected populations [ 1 ]. In view of the frequency and comparatively small therapeutic range of thyroid hormones, interactions with other drugs are of considerable importance. The absorption of iodothyronines is known to be influenced by numerous substances, including antacid drugs [ 2 ] [ 3 ]. Sufficient gastric acidity has been assumed to be a prerequisite for effective iodothyronine resorption as a result [ 4 ]. However, whether thyroid replacement therapy is disturbed in patients treated with proton-pump inhibitors is still unknown, although this most effective form of acid inhibition is increasingly prescribed. To address this question, we have conducted a study in order to answer the question as to whether proton-pump inhibition affects levothyroxine resorption.
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LT4 absorption was unaltered with use of PPIs (146,147) and histamine-2 blockers (147) for a 1-week period in two other studies in healthy volunteers.
“LT4 absorption was unaltered with use of PPIs (146,147) and histamine-2 blockers (147) for a 1-week period in two other studies in healthy volunteers.”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [146]
Clinical studies of one week pantoprazole, 3 months omeprazole, and one week esomeprazole did not find significant intergroup differences in TSH or thyroid hormone levels.
“In contrast, various clinical studies of one week of treatment with pantoprazole [ 74 ], 3 months of treatment with omeprazole [ 75 ], and a week’s treatment with esomeprazole [ 76 ] did not find significant intergroup differences in the TSH or thyroid hormone levels.”
From Factors influencing the levothyroxine dose in the hormone replacement therapy of primary hypothyroidism in adults (2022) · cites this paper as [74]
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- Authors
- Dietrich, J. W., Gieselbrecht, K., Holl, R. W., & Boehm, B. O.
- Affiliations
- University Hospitals of the Ruhr-University of Bochum (DE)
- Universität Ulm (DE)
- Venue
- Hormone and Metabolic Research
- Publisher
- Georg Thieme Verlag KG
- Published
- 2006-01
- Volume
- 38
- Issue
- 1
- Pages
- 57-59
- ISSN
- 0018-5043 (ISSN-L)
- 1439-4286
- OpenAlex
- W2086392179
- Cited by
- 44
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 6 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 1 · 2018: 2 · 2017: 3 · 2015: 4 · 2014: 6 · 2012: 1
- FWCI
- 1.55
- Type
- journal article
- Language
- de
- Open access
- closed
- Locations
- Hormone and Metabolic Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- levothyroxine, proton pump inhibitors, drug absorption, drug interactions, iodothyronines, gastric acidity, thyroid hormone replacement, antacids
- MeSH terms
- Absorption, Antacids, Drug Antagonism, Drug Synergism, Female, Gastric Acidity Determination, Humans, Hypothyroidism, Male, Thyroxine, Hormone Replacement Therapy, Proton Pump Inhibitors
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