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A Report of the Mayo Clinic Experience on the Levothyroxine Absorption Test
Open accessAbstract
BackgroundThe optimal starting replacement dose of levothyroxine (L-T 4 ) related to body weight (BW) is about 1.6 to 1.8 μg/kg/day in hypothyroid adults (1).This dosage can vary according to the etiology and severity of the hypothyroidism, the patient's age, and any associated comorbidities (1).Consequently, the dose of L-T 4 should be adjusted on the basis of the evaluation of serum thyrotropin (TSH) levels, which represent the best marker of the adequacy of L-T 4 prescription in primary hypothyroidism; the TSH cut-off level should be targeted according to the patient's age and other factors, as mentioned above (1,2).
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A levothyroxine absorption test must be used to differentiate true malabsorption from nonadherence or pseudo-malabsorption.
“In clinical practice, the levothyroxine absorption test is part of the workup of patients with “refractory hypothyroidism” to differentiate true malabsorption from nonadherence or pseudo-malabsorption [3, 6].”
From Levothyroxine Absorption Test With the Daily Levothyroxine Dose in Patients With “Refractory Hypothyroidism” (2025) · cites this paper as [6]
The Conclusions say the absorption test can help distinguish malabsorption from pseudomalabsorption in adults with refractory hypothyroidism. The Abstract says some clinicians support its use, while the Commentary says protocols lack established standards. These passages support its diagnostic role, but not the claim that it must be used. (LLM, conf=0.86)
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References 9 · Cited by 4
Research works printed but not linked: 1
- Lips DJ, 2004, Neth J Med, 62, 114
Metadata
- Authors
- Biondi, B.
- Affiliations
- University of Naples Federico II (IT)
- Corresponding author
- Biondi, Bernadette
- ORCID
- Biondi, Bernadette
- Venue
- Clinical Thyroidology
- Publisher
- SAGE Publications
- Published
- 2020-01-01
- Volume
- 32
- Issue
- 1
- Pages
- 6-8
- ISSN
- 2329-9711 (ISSN-L)
- 2329-972X
- OpenAlex
- W2998226874
- Cited by
- 4
- References
- 9
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 1 · 2021: 1
- FWCI
- 0.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Thyroidology (publishedVersion)
- 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, thyroid hormone replacement, starting dose, body weight, serum thyrotropin, dose adjustment
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