Subcutaneous application of levothyroxine as successful treatment option in a patient with malabsorption
Open accessAbstract
BACKGROUND: Hypothyroidism can usually be treated effectively by oral levothyroxine supplementation. There are, however, some rare circumstances, when oral levothyroxine application is not sufficient, for example malabsorption, interactions with food or other medications, or various gastrointestinal diseases. CASE REPORT: We present a 42 year old woman with refractory and severe symptomatic hypothyroidism after subtotal thyroidectomy in spite of high dose oral levothyroxine supplementation. By stepwise increasing oral levothyroxine dosage up to 2200 micrograms plus 80 micrograms of thyronine, no sufficient substitution could be achieved. After suspicion of enteral malabsorption due to a pathological D-Xylose-test, subcutaneous levothyroxine supplementation was started. Finally, a sustained euthyroid state could be achieved. CONCLUSIONS: For selected patients who do not respond to oral treatment subcutaneous application of levothyroxine can be a suitable and effective therapy.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
An individual with hypothyroidism refractory to oral LT4 due to severe malabsorption achieved euthyroidism after receiving a subcutaneous LT4 injection at a dose of 500 μg/week.
“An individual with hypothyroidism refractory to oral LT4 due to severe malabsorption was reported to achieve euthyroidism after receiving a SC LT4 injection at a dose of 500 µg/week (248).”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [248]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Conditions and drugs interfering with thyroxine absorption
Liwanpo, L., & Hershman, J. M. (2009) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2009.06.006 · Cited by 222 · see citing works
Overt and Subclinical Hypothyroidism
Khandelwal, D., & Tandon, N. (2011) · Drugs · doi:10.2165/11598070-000000000-00000 · Cited by 199 · see citing works
Oliveira, J. C., Macedo, M. M., Luís, A. S., & Galvão-Teles, A. (2022) · Acta Médica Portuguesa · doi:10.20344/amp.5829 · Cited by 116 · see citing works
Pseudomalabsorption of levothyroxine
Ain, K. B. (1991) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1991.03470150090036 · Cited by 100 · see citing works
Bolk, N., Visser, T. J., Kalsbeek, A., van Domburg, R. T., & Berghout, A. (2006) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2006.02681.x · Cited by 96 · see citing works
Absorption of Levothyroxine When Coadministered with Various Calcium Formulations
Zamfirescu, I., & Carlson, H. E. (2011) · Thyroid · doi:10.1089/thy.2010.0296 · Cited by 76 · see citing works
Ward, L. S. (2010) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/s0004-27302010000500002 · Cited by 53 · see citing works
TSH-Based Protocol, Tablet Instability, and Absorption Effects on L-T <sub>4</sub> Bioequivalence
Eisenberg, M., & Distefano, J. J. (2009) · Thyroid · doi:10.1089/thy.2008.0148 · Cited by 43 · see citing works
Pseudomalabsorption of Levothyroxine. A Case Report.
Ogawa, D., Otsuka, F., Mimura, Y., UENO, A., HASHIMOTO, H., Kishida, M., Ogura, T., & Makino, H. (2000) · Endocrine Journal · doi:10.1507/endocrj.47.45 · Cited by 35 · see citing works
Tönjes, A., Karger, S., Koch, C. A., Paschke, R., Tannapfel, A., Stümvoll, M., & Führer, D. (2006) · Thyroid · doi:10.1089/thy.2006.16.1047 · Cited by 28 · see citing works
Hasselström, K., Siersbæk‐Nielsen, K., Lumholtz, B., Faber, J. O., KIRKEGAARD, C., & Friis, T. (1985) · European Journal of Endocrinology · doi:10.1530/acta.0.1100483 · Cited by 25 · see citing works
[A rare case of malabsorption of thyroid hormones].
Nobre, E. L., Jorge, Z., Anselmo, J., Lopes, C., César, R., Santos, V., & de Castro, J. J. (2004) · PubMed · Cited by 9 · see citing works
A curious case of refractory hypothyroidism due to selective malabsorption of oral thyroxine
Damle, N., Bal, C., Soundararajan, R., Kumar, P., & Durgapal, P. (2012) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.95716 · Cited by 9 · see citing works
An unusual case of Hashimoto′s thyroiditis with four lobed thyroid gland
Dar, R., Parray, F. Q., Wani, S., & Chowdri, N. (2012) · North American Journal of Medical Sciences · doi:10.4103/1947-2714.93881 · Cited by 6 · see citing works
Mixed medullary thyroid cancer and follicular cancer
Yaturu, S., Fontinot, J., & Rowland, T. (2011) · American Journal of Case Reports · doi:10.12659/ajcr.881371 · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Diagnosis and management of treatment-refractory hypothyroidism: an expert consensus report
Centanni, M., Benvenga, S., & Sachmechi, I. (2017) · Journal of Endocrinological Investigation · doi:10.1007/s40618-017-0706-y · Cited by 113 · see citing works
McMillan, M., Rotenberg, K. S., Vora, K., Sterman, A. B., Thevathasan, L., Ryan, M. F., Mehra, M., & Sandulli, W. (2016) · Drugs in R&D · doi:10.1007/s40268-015-0116-6 · Cited by 64 · see citing works
Levothyroxine: conventional and novel drug delivery formulations.
Liu, H., Li, W., Zhang, W., Sun, S., & Chen, C. (2023) · Endocrine Reviews · doi:10.1210/endrev/bnac030 · Cited by 63 · see citing works
Thyroid disorders and gastrointestinal dysmotility: an old association
Xu, G.-M., Hu, M.-X., Li, S.-Y., Ran, X., Zhang, H., & Ding, X.-F. (2024) · Frontiers in Physiology · doi:10.3389/fphys.2024.1389113 · Cited by 43 · see citing works
Poly(caprolactone)-based subcutaneous implant for sustained delivery of levothyroxine
Stewart, S. A., Domínguez-Robles, J., Utomo, E., Picco, C. J., Corduas, F., Mancuso, E., Amir, M. N., Bahar, M. A., Sumarheni, S., Donnelly, R. F., et al. (2021) · International Journal of Pharmaceutics · doi:10.1016/j.ijpharm.2021.121011 · Cited by 35 · see citing works
- Authors
- Groener, J. B., Lehnhoff, D., Piel, D., Nawroth, P. P., Schanz, J., & Rudofsky, G.
- Affiliations
- Heidelberg University (DE)
- Corresponding author
- Rudofsky, Gottfried
- Venue
- American Journal of Case Reports
- Published
- 2013
- Volume
- 14
- Pages
- 48-51
- ISSN
- 1941-5923 (ISSN-L)
- PMC
- PMC3614336
- OpenAlex
- W2039669293
- Cited by
- 23
- References
- 15
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 5 · 2020: 2 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 1 · 2015: 1
- FWCI
- 0.53
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- American Journal of Case Reports (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (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 › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- hypothyroidism, subtotal thyroidectomy, refractory hypothyroidism, thyronine, D-xylose test, thyroid hormone replacement
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
