Levothyroxine interactions with food and dietary supplements – a systematic review
Open accessAbstract
Levothyroxine (l-thyroxine, l-T4) is a drug of choice for treating congenital and primary hypothyroidism. Although clinically significant interactions between l-T4 and food can alter the safety and efficacy of the treatment, they still seem to be generally underestimated by patients, physicians and pharmacists. This review aimed to investigate the effects of meals, beverages, and dietary supplements consumption on l-T4 pharmacokinetics and pharmacodynamics, to identify the most evident interactions, and to perform the recommendations for safe co-administering of l-T4 and food. A total of 121 studies were identified following a systematic literature search adhering to PRISMA guidelines. After full-text evaluation, 63 studies were included. The results proved that l-T4 ingestion in the morning and at bedtime are equally effective, and also that the co-administration of l-T4 with food depends on the drug formulation. We found limited evidence for l-T4 interactions with coffee, soy products, fiber, calcium or iron supplements, and enteral nutrition but interestingly they all resulted in decreased l-T4 absorption. The altered l-T4 efficacy when ingested with milk, juices, papaya, aluminium-containing preparations, and chromium supplements, as well as observed enhancement effect of vitamin C on l-T4 absorption, shall be further investigated in larger, well-designed studies. Novel formulations are likely to solve the problem of coffee, calcium and iron induced malabsorption of l-T4. Maintaining a proper time interval between l-T4 and food intake, especially for coffee and calcium, or iron supplements, provides another effective method of eliminating such interactions.
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Supplements containing ferrous salts or treatment with ferrous preparations decrease LT4 bioavailability by adsorbing LT4.
“Supplements containing ferrous salts or treatment with ferrous preparations decrease LT4 bioavailability by adsorbing LT4 (46).”
From ETA guidelines for the use of levothyroxine sodium preparations in monotherapy to optimize the treatment of hypothyroidism (2025) · cites this paper as [46]
Section 2.10 reports that iron supplements and ferrous preparations can reduce LT4 absorption and efficacy. It describes adsorption as a proposed mechanism, alongside formation of insoluble complexes; it does not establish adsorption as the mechanism for ferrous preparations. No page number is available in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measuredSome types of foods and dietary supplements have been reported to reduce LT4 absorption, including soy, coffee, calcium, and grapefruit.
“Some types of foods and dietary supplements have been reported to reduce LT4 absorption, including soy, coffee, calcium, and grapefruit (14, 46) (Table 1).”
From ETA guidelines for the use of levothyroxine sodium preparations in monotherapy to optimize the treatment of hypothyroidism (2025) · cites this paper as [46]
Aluminum and chromium may reduce levothyroxine bioavailability, but evidence is limited.
“Aluminum and chromium may also decrease LT4 bioavailability, although evidence on this is limited.34”
From Refractory hypothyroidism: unraveling the complexities of diagnosis and management (2023) · cites this paper as [34]
Regular intake of 600 to 1000 mg calcium carbonate near levothyroxine can raise TSH, with the effect lessening as the interval between them increases.
“Regular consumption of 600 to 1000 mg of calcium carbonate near the time of taking LT4 can elevate TSH levels, although this situation diminishes as the time interval between them increases.34,52”
From Refractory hypothyroidism: unraveling the complexities of diagnosis and management (2023) · cites this paper as [34]
Not waiting at least 30 minutes before breakfast after levothyroxine, or taking it with a beverage other than water, may reduce levothyroxine absorption.
“Failing to observe a minimum interval of 30 min before having breakfast after administering the LT4 dose, 33 or consuming it not solely with water, but alongside another beverage, [34][35][36][37] are circumstances that may impede the absorption of LT4.”
From Refractory hypothyroidism: unraveling the complexities of diagnosis and management (2023) · cites this paper as [34]
Milk and coffee interfere with levothyroxine absorption when taken together with the medication, though the exact necessary time interval is unknown.
“Milk and coffee interfere with LT4 absorption when consumed together with the medication, although the exact time interval for adequate absorption remains unknown.34”
From Refractory hypothyroidism: unraveling the complexities of diagnosis and management (2023) · cites this paper as [34]
A systematic review found that high dietary fiber intake may cause levothyroxine malabsorption through adsorption to fiber and increased bowel movements.
“A systematic review found that high dietary fiber intake may result in LT4 malabsorption due to LT4 adsorption to fiber and increased bowel movements, suggesting monitoring of TSH levels.34”
From Refractory hypothyroidism: unraveling the complexities of diagnosis and management (2023) · cites this paper as [34]
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Cites
Hypothyroidism in Context: Where We’ve Been and Where We’re Going
Chiovato, L., Magri, F., & Carlé, A. (2019) · Advances in Therapy · doi:10.1007/s12325-019-01080-8 · Cited by 491 · cited 1× · see citing works
“Levothyroxine ( L ‐ thyroxine, L ‐ T4) is a drug of choice for treating primary hypothyroidism, which in developing countries generally occurs due to Hashimoto thyroiditis, thyroidectomy, or iodine deficiency [1].”
BackgroundFerrous sulfate reduces thyroxine efficacy in patients with hypothyroidism
Campbell, N. R. C., Hasinoff, B. B., Stalts, H., Rao, B., & Wong, N. C. W. (1992) · Annals of Internal Medicine · doi:10.7326/0003-4819-117-12-1010 · Cited by 231 · cited 3× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundConditions 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
Fruit juice inhibition of uptake transport: a new type of food–drug interaction
Bailey, D. G. (2010) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.2010.03722.x · Cited by 222 · cited 1× · see citing works
“Active ingredients of juices—especially grapefruit, orange, and apple juice—may block the transporters [67,68].”
BackgroundEffect of calcium carbonate on the absorption of levothyroxine
Singh, N. (2000) · JAMA · doi:10.1001/jama.283.21.2822 · Cited by 219 · cited 4× · see citing works
“[77] indicated that calcium carbonate may reduce L-T4 absorption.”
BackgroundInfluentialTiming of levothyroxine administration affects serum thyrotropin concentration
Bach-Huynh, T.-G., Nayak, B., Loh, J., Soldin, S., & Jonklaas, J. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-0860 · Cited by 198 · cited 1× · see citing works
“Similar results were obtained in many other studies [26–30].”
ResultYetley, E. A. D. (2007) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/85.1.269s · Cited by 195 · cited 1× · see citing works
“Di ‐ and trivalent elements, especially calcium and iron, may decrease L ‐ T4 bioavailability, making treatment less effective [73,74].”
BackgroundAltered intestinal absorption of L-thyroxine caused by coffee
Benvenga, S., Bartolone, L., Pappalardo, M. A., Russo, A., Lapa, D., Giorgianni, G., Saraceno, G., & Trimarchi, F. (2008) · Thyroid · doi:10.1089/thy.2007.0222 · Cited by 191 · cited 4× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundInfluentialA review of the pharmacokinetics of levothyroxine for the treatment of hypothyroidism
Colucci, P., Yue, C. S., Ducharme, M., Benvenga, S., Principal Scientist, L. A. C. I., Principal Scientist, L. A. C. I. A. P. C., President and CEO, L. A. C. I., & Professor of Medicine, D. (2010) · European Endocrinology · doi:10.17925/ee.2013.09.01.40 · Cited by 167 · cited 4× · see citing works
“…to carrying L ‐ T4 from the small intestine to the bloodstream, i.e. the organic anion ‐ transporting polypeptide (OATP) family (such as OATP1A2, OATP1B1, OATP1C1, etc.), the monocarboxylate transporter (MCT) family or NTCP (sodium ‐ taurocholate co ‐ transporting polypeptide) transporters [5,66].”
BackgroundResultInfluentialGastrointestinal malabsorption of thyroxine
Virili, C., Antonelli, A., Santaguida, M. G., Benvenga, S., & Centanni, M. (2019) · Endocrine Reviews · doi:10.1210/er.2018-00168 · Cited by 164 · cited 5× · see citing works
“The results of this study, along with several other [33,37] support the recommendation to postpone food by at least 30–60 min after L ‐ T4 tablet ingestion [5,6].”
BackgroundResultInfluentialDelayed Intestinal Absorption of Levothyroxine
BENVENGA, S., BARTOLONE, L., SQUADRITO, S., GIUDICE, F. L., & TRIMARCHI, F. (1995) · Thyroid · doi:10.1089/thy.1995.5.249 · Cited by 156 · cited 4× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundResultInfluentialAspects of the absorption of oral L-thyroxine in normal man
Wenzel, K. W., & Kirschsieper, H. E. (1977) · Metabolism · doi:10.1016/0026-0495(77)90121-4 · Cited by 151 · cited 3× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundLiel, Y., Harman-Boehm, I., & Shany, S. (1996) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.81.2.8636317 · Cited by 129 · see citing works
Effects of Evening vs Morning Levothyroxine Intake: A Randomized Double-blind Crossover Trial
Bolk, N. (2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.436 · Cited by 128 · cited 1× · see citing works
“Similar results were obtained in many other studies [26–30].”
ResultPabla, D., Akhlaghi, F., & Zia, H. (2009) · European Journal of Pharmaceutics and Biopharmaceutics · doi:10.1016/j.ejpb.2008.10.008 · Cited by 124 · cited 1× · see citing works
“L ‐ T4 in soft gel capsules dissolves better in increased pH [21] as well.”
BackgroundUse Of Soy Protein Supplement And Resultant Need For Increased Dose Of Levothyroxine
Bell, D. S. H., & Montanya, E. (2001) · Endocrine Practice · doi:10.4158/ep.7.3.193 · Cited by 124 · cited 3× · see citing works
“Soy products (soy-protein cocktails, soy-based infant formulas) case reports [52,53,55,57], case series [54], retrospective cohort study [56] adsorption of L-T4 on the surface of soy protein malabsorption of L-T4, impaired efficacy of treatment advise to separate soy protein and L-T4 intake by 1 h monitor thyroid para…”
BackgroundSachmechi, I., Reich, D. M., Aninyei, M., Wibowo, F., Gupta, G., & Kim, P. J. (2007) · Endocrine Practice · doi:10.4158/ep.13.4.345 · Cited by 112 · cited 1× · see citing works
“Several studies confirmed that patients with impaired gastric acid secretion, either due to the disease, or using pomp proton inhibitors (PPI), may need higher L ‐ T4 doses to achieve the desired TSH level [10,11].”
BackgroundSoy formula complicates management of congenital hypothyroidism
Conrad, S. (2004) · Archives of Disease in Childhood · doi:10.1136/adc.2002.009365 · Cited by 107 · cited 2× · see citing works
“Conrad et al. [56] confirmed the negative influence of soy isoflavones on the L ‐ T4 treatment efficacy (measured by TSH level) for a group of 78 infants with L ‐ T4 congenital hypothyroidism.”
BackgroundKung, A. W. C., & Yeung, S. S. (1996) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.81.3.8772604 · Cited by 100 · cited 1× · see citing works
“The effect of L ‐ T4 treatment on bone mineral density is still an open question [76] but patients with hypothyroidism, especially postmenopausal women, may often use calcium supplements to prevent L ‐ T4 ‐ induced osteoporosis [77,78].”
BackgroundVita, R., Saraceno, G., Trimarchi, F., & Benvenga, S. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-2684 · Cited by 99 · cited 1× · see citing works
“Switching from the tablets to the oral liquid formulation has improved L ‐ T4 treatment efficacy in 24 patients ingesting PPI [19] and 11 ingesting other interfering drugs [20].”
BackgroundCoffee and autoimmunity: More than a mere hot beverage!
Sharif, Κ., Watad, ., Bragazzi, N. L., Adawi, M., Amital, H., & Shoenfeld, Y. (2017) · Autoimmunity Reviews · doi:10.1016/j.autrev.2017.05.007 · Cited by 98 · cited 1× · see citing works
“The proposed mechanism for this interaction was the sequestration of L ‐ T4 by coffee and in consequence, altered intestinal absorption of the drug [60].”
BackgroundBolk, 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
Primary and secondary thyroid hormone transporters
Kinne, A., Schülein, R., & Krause, G. (2011) · Thyroid Research · doi:10.1186/1756-6614-4-s1-s7 · Cited by 94 · cited 1× · see citing works
“…to carrying L ‐ T4 from the small intestine to the bloodstream, i.e. the organic anion ‐ transporting polypeptide (OATP) family (such as OATP1A2, OATP1B1, OATP1C1, etc.), the monocarboxylate transporter (MCT) family or NTCP (sodium ‐ taurocholate co ‐ transporting polypeptide) transporters [5,66].”
BackgroundVita, R., Saraceno, G., Trimarchi, F., & Benvenga, S. (2013) · Endocrine · doi:10.1007/s12020-012-9772-2 · Cited by 91 · cited 2× · see citing works
“…(espresso, drip coffee, barley coffee) case report [63], case series [61,62], uncontrolled clinical study [65], non ‐ randomized cross ‐ over study [64] the sequestration of L ‐ T4 by coffee malabsorption of L ‐ T4, impaired efficacy of treatment advise to delay coffee intake by 1 h after L ‐ T4…”
BackgroundThyroid refractoriness in an athyreotic cretin fed soybean formula
Pinchera, A., MacGillivray, M. H., Crawford, J. D., & Freeman, A. G. (1965) · New England Journal of Medicine · doi:10.1056/nejm196507082730205 · Cited by 90 · cited 2× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundChorazy, P. A., Himelhoch, S. S., Hopwood, N. J., Greger, N. G., & Postellon, D. C. (1995) · PEDIATRICS · doi:10.1542/peds.96.1.148 · Cited by 89 · cited 2× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundJabbar, M. A., Larrea, J., & Shaw, R. A. (1997) · Journal of the American College of Nutrition · doi:10.1080/07315724.1997.10718686 · Cited by 87 · cited 2× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundNonspecific intestinal adsorption of levothyroxine by aluminum hydroxide
Liel, Y., Sperber, A. D., & Shany, S. (1994) · The American Journal of Medicine · doi:10.1016/0002-9343(94)90303-4 · Cited by 83 · cited 5× · see citing works
“[75] 5, hypothyroid not specified Not specified aluminium hydroxide ↑ TSH level (from 2.”
BackgroundInfluentialNew medications which decrease levothyroxine absorption
John-Kalarickal, J., Pearlman, G., & Carlson, H. E. (2007) · Thyroid · doi:10.1089/thy.2007.0060 · Cited by 82 · cited 4× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundInfluentialPhilippé, J., & Dibner, C. (2014) · Journal of Biological Rhythms · doi:10.1177/0748730414557634 · Cited by 82 · see citing works
Yue, C., Scarsi, C., & Ducharme, M. P. (2012) · Arzneimittelforschung · doi:10.1055/s-0032-1329951 · Cited by 81 · cited 2× · see citing works
“Greater early exposure and faster time to maximal concentration can minimize the risk of drug ‐ food interactions [15].”
BackgroundCappelli, C., Pirola, I., Daffini, L., Formenti, A., Iacobello, C., Cristiano, A., Gandossi, E., Agabiti Rosei, E., & Castellano, M. (2016) · Thyroid · doi:10.1089/thy.2015.0422 · Cited by 80 · cited 3× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundMethodThe Acute Effect of Calcium Carbonate on the Intestinal Absorption of Levothyroxine
Singh, N., Weisler, S. L., & Hershman, J. M. (2001) · Thyroid · doi:10.1089/105072501753211046 · Cited by 77 · cited 3× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundResultAdverse events associated with interactions with dietary and herbal supplements among inpatients
Levy, I., Attias, S., Ben‐Arye, E., Goldstein, L. H., & Schiff, E. (2016) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.13158 · Cited by 77 · 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 · cited 4× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundInfluentialEffects of grapefruit juice on the absorption of levothyroxine
Lilja, J. J., Laitinen, K., & Neuvonen, P. J. (2005) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.2005.02433.x · Cited by 74 · cited 4× · see citing works
“[69] reported a case of a 36-year-old hypothyroid woman, successfully treated with L-T4 (100 μg daily).”
BackgroundInfluentialRecommendations for the use of medications with continuous enteral nutrition
Wohlt, P. D., Zheng, L., Gunderson, S., Balzar, S. A., Johnson, B. D., & Fish, J. T. (2009) · American Journal of Health-System Pharmacy · doi:10.2146/ajhp080632 · Cited by 70 · cited 1× · see citing works
“However, Wohlt et al. [104] stated that this mechanism is probably clinically insignificant, and suggested that altered L ‐ T4 absorption is rather due to the ingestion together with food.”
BackgroundA. Irving, S., Vadiveloo, T., & Leese, G. P. (2015) · Clinical Endocrinology · doi:10.1111/cen.12559 · Cited by 69 · cited 8× · see citing works
“Several studies confirmed that patients with impaired gastric acid secretion, either due to the disease, or using pomp proton inhibitors (PPI), may need higher L-T4 doses to achieve the desired TSH level [10,11].”
BackgroundInfluentialThyroxine softgel capsule in patients with gastric-related T4 malabsorption
Santaguida, M. G., Virili, C., Duca, S. C. D., Cellini, M., Gatto, I., Brusca, N., De Vito, C., Gargano, L., & Centanni, M. (2015) · Endocrine · doi:10.1007/s12020-014-0476-7 · Cited by 68 · cited 1× · see citing works
“This formulation, when compared to the tablets, can improve TSH levels both in patients with gastric diseases ( H. pylori infection, chronic gastritis, etc.) and with no proven malabsorption [22,23].”
BackgroundSystematic review and meta-analysis on the effect of soy on thyroid function
Otun, J., Sahebkar, A., Östlundh, L., Atkin, S. L., & Sathyapalan, T. (2019) · Scientific Reports · doi:10.1038/s41598-019-40647-x · Cited by 68 · see citing works
Sperber, A. D. (1992) · Archives of Internal Medicine · doi:10.1001/archinte.1992.00400130181024 · Cited by 66 · cited 2× · see citing works
“…changing formulation from tablets to oral liquid form/gel capsules monitor thyroid parameters more frequently Aluminium (hydroxide) case reports [93,94], uncontrolled clinical study [75] unspecific adsorption of L ‐ T4, creating insoluble or sparingly soluble complexes in the intestine…”
BackgroundMcMillan, 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 · cited 1× · see citing works
“McMillan et al. [3] surveyed hypothyroid patients to determine the factors affecting L ‐ T4 therapy.”
BackgroundSerum Thyrotropin Levels Following Levothyroxine Administration at Breakfast
Perez, C. L. S., Araki, F. S., Graf, H., & de Carvalho, G. A. (2013) · Thyroid · doi:10.1089/thy.2012.0435 · Cited by 63 · cited 4× · see citing works
“[38] concluded that the intake of L-T4 tablets with food can be safe and well-tolerated alternative for non-adherent patients, though it requires more frequent monitoring of TSH levels.”
BackgroundMethodInfluentialVirili, C., Giovanella, L., Fallahi, P., Antonelli, A., Santaguida, M. G., Centanni, M., & Trimboli, P. (2018) · Frontiers in Endocrinology · doi:10.3389/fendo.2018.00010 · Cited by 61 · cited 1× · see citing works
“Liquid L ‐ T4 lowers TSH levels more effectively in comparison to the tablets with the same dose, both in patients with and without malabsorption [16–18].”
BackgroundChromium picolinate supplementation for overweight or obese adults
Tian, H., Guo, X., Wang, X., He, Z., Sun, R., Ge, S., & Zhang, Z. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010063.pub2 · Cited by 57 · cited 1× · see citing works
“Although the effectiveness and safety of chromium picolinate supplementation in overweight and obese people are controversial [96,97], patients with thyroid diseases may use chromium supplements to control body weight.”
BackgroundGuglielmi, R., Grimaldi, F., Negro, R., Frasoldati, A., Misischi, I., Graziano, F., Cipri, C., Guastamacchia, E., Triggiani, V., & Papini, E. (2018) · Endocrine, Metabolic & Immune Disorders - Drug Targets · doi:10.2174/1871530318666180125155348 · Cited by 57 · see citing works
Polypharmacy and Food–Drug Interactions Among Older Persons: A Review
Heuberger, R. (2012) · Journal of Nutrition in Gerontology and Geriatrics · doi:10.1080/21551197.2012.729902 · Cited by 57 · cited 1× · see citing works
“Heuberger [106] and Pa ś ko et al. [107] provided a few reasons for that, such as undefined framework study, hardly available appropriate samples, or measurement difficulties.”
BackgroundThyroxine treatment: absorption, malabsorption, and novel therapeutic approaches
Centanni, M. (2013) · Endocrine · doi:10.1007/s12020-012-9814-9 · Cited by 56 · cited 1× · see citing works
“In patients with hypothyroidism, time to achieve C max (t max ) delays from 2 h to 3 h, the volume of distribution decreases from 14.7 L to 11.6 L , and the bioavailability can be higher than standard 60–80% [6–8].”
BackgroundInfluentialMOHAMED SHAKIR, K. M., CHUTE, J. P., APRILL, B. S., & LAZARUS, A. A. (1997) · Southern Medical Journal · doi:10.1097/00007611-199706000-00011 · Cited by 55 · cited 4× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundInfluentialWard, L. S. (2010) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/s0004-27302010000500002 · Cited by 53 · cited 1× · see citing works
“L ‐ T4 is absorbed from the tablet within 20–30 min after ingestion; it takes about 3 h to complete the absorption process [7].”
BackgroundFallahi, P., Ferrari, S. M., & Antonelli, A. (2016) · Endocrine · doi:10.1007/s12020-015-0836-y · Cited by 53 · cited 2× · see citing works
“Liquid L ‐ T4 is absorbed faster than its solid form [15], it was also found to be less dependable on gastric pH and conditions causing malabsorption [9,16].”
BackgroundRajput, R., Chatterjee, S., & Rajput, M. (2011) · Journal of Thyroid Research · doi:10.4061/2011/505239 · Cited by 52 · see citing works
Levothyroxine absorption in health and disease, and new therapeutic perspectives.
Ianiro, G., Mangiola, F., Rienzo, T. A. D., Bibbò, S., Franceschi, F., Greco, A. V., & Gasbarrini, A. (2014) · PubMed · Cited by 51 · see citing works
Benvenga, S., Di Bari, F., & Vita, R. (2017) · Endocrine · doi:10.1007/s12020-017-1244-2 · Cited by 51 · cited 4× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundInfluentialSecond generation H1 - antihistamines interaction with food and alcohol—A systematic review
Paśko, P., Rodacki, T., Domagała-Rodacka, R., Palimonka, K., Marcinkowska, M., & Owczarek, D. (2017) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2017.06.008 · Cited by 50 · cited 1× · see citing works
“Active ingredients of juices—especially grapefruit, orange, and apple juice—may block the transporters [67,68].”
BackgroundPirola, I., Daffini, L., Gandossi, E., Lombardi, D., Formenti, A., Castellano, M., & Cappelli, C. (2014) · Journal of Endocrinological Investigation · doi:10.1007/s40618-014-0082-9 · Cited by 47 · cited 1× · see citing works
“Pirola et al. [105] compared the effect of administering different formulations of L ‐ T4, in a daily dose of 1.6 μ g/kg, via an enteral feeding tube.”
BackgroundInfluentialMersebach, H., Rasmussen, Å. K., Kirkegaard, L., & Feldt‐Rasmussen, U. (1999) · Pharmacology & Toxicology · doi:10.1111/j.1600-0773.1999.tb00883.x · Cited by 45 · cited 1× · see citing works
“Several case studies reported L ‐ T4 malabsorption due to concomitant use of aluminium hydroxide [94,95].”
BackgroundEffect of vitamin C on the absorption of levothyroxine in patients with hypothyroidism and gastritis
Jubiz, W., & Ramirez, M. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-4360 · Cited by 45 · cited 3× · see citing works
“Vitamin C uncontrolled clinical study [100], non-randomized cross-over study [99] lowering of gastric pH enhanced absorption of L-T4 consider advising concomitant ingestion of vitamin C and L-T4”
BackgroundVita, R., Di Bari, F., & Benvenga, S. (2017) · Expert Opinion on Drug Delivery · doi:10.1080/17425247.2017.1290604 · Cited by 43 · cited 1× · see citing works
“Switching from the tablets to the oral liquid formulation has improved L ‐ T4 treatment efficacy in 24 patients ingesting PPI [19] and 11 ingesting other interfering drugs [20].”
BackgroundEffects of Pharmacological Fiber Supplements on Levothyroxine Absorption
Chiu, A. C., & Sherman, S. I. (1998) · Thyroid® · doi:10.1089/thy.1998.8.667 · Cited by 41 · cited 4× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundInfluentialOral liquid levothyroxine treatment at breakfast: a mistake?
Cappelli, C., Pirola, I., Gandossi, E., Formenti, A., & Castellano, M. (2014) · European Journal of Endocrinology · doi:10.1530/eje-13-0693 · Cited by 41 · cited 3× · see citing works
“Coffee (espresso, drip coffee, barley coffee) case report [63], case series [61,62], uncontrolled clinical study [65], non-randomized cross-over study [64] the sequestration of L-T4 by coffee malabsorption of L-T4, impaired efficacy of treatment advise to delay coffee intake by 1 h after L-T4 administration consider c…”
BackgroundResultCsako, G., McGriff, N. J., Rotman-Pikielny, P., Sarlis, N. J., & Pucino, F. (2001) · Annals of Pharmacotherapy · doi:10.1345/aph.1a031 · Cited by 40 · cited 1× · see citing works
“…of treatment cannot be made due to the insufficient evidence advise to avoid excessive intake Calcium (carbonate, acetate, citrate) case reports [81–83], case series [80], retrospective cohort studies [11,84,86], prospective cohort study [77], uncontrolled clinical study [87], non ‐ randomized…”
BackgroundThe Effect of Levothyroxine Therapy on Bone Mineral Density: A Systematic Review of the Literature
Schneider, R., & Reiners, C. (2004) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-2003-44704 · Cited by 40 · cited 1× · see citing works
“The effect of L ‐ T4 treatment on bone mineral density is still an open question [76] but patients with hypothyroidism, especially postmenopausal women, may often use calcium supplements to prevent L ‐ T4 ‐ induced osteoporosis [77,78].”
BackgroundUnawareness of the Effects of Soy Intake on the Management of Congenital Hypothyroidism
Fruzza, A. G., Demeterco‐Berggren, C., & Jones, K. L. (2012) · PEDIATRICS · doi:10.1542/peds.2011-3350 · Cited by 40 · cited 2× · see citing works
“…more frequently, adjust L ‐ T4 doses when needed Soy products (soy ‐ protein cocktails, soy ‐ based infant formulas) case reports [52], [53], [55] [57], case series [54], retrospective cohort study [56] adsorption of L ‐ T4 on the surface of soy protein malabsorption of L ‐ T4, impaired…”
BackgroundThe Effect of Famotidine, Esomeprazole, and Ezetimibe on Levothyroxine Absorption
Ananthakrishnan, S., Braverman, L. E., Levin, R. M., Magnani, B., & Pearce, E. N. (2008) · Thyroid · doi:10.1089/thy.2007.0381 · Cited by 38 · cited 1× · see citing works
“Pantoprazole and esomeprazole do not seem to alter pharmacokinetic parameters of L-T4, though the evidence is insufficient to prove its safety [13,14].”
BackgroundEffect of phosphate binders upon TSH and l-thyroxine dose in patients on thyroid replacement
Diskin, C. J., Stokes, T. J., Dansby, L. M., Radcliff, L., & Carter, T. B. (2007) · International Urology and Nephrology · doi:10.1007/s11255-006-9166-6 · Cited by 36 · cited 3× · see citing works
“[84] 65, hypothyroid 95–98 Not specified calcium carbonate ↑ TSH level (23.”
BackgroundTsang, C., Taghizadeh, M., Aghabagheri, E., Asemi, Z., & Jafarnejad, S. (2019) · Clinical Obesity · doi:10.1111/cob.12313 · Cited by 36 · cited 1× · see citing works
“Although the effectiveness and safety of chromium picolinate supplementation in overweight and obese people are controversial [96,97], patients with thyroid diseases may use chromium supplements to control body weight.”
BackgroundCalcium Carbonate and Reduction of Levothyroxine Efficacy
Schneyer, C. R. (1998) · JAMA · doi:10.1001/jama.279.10.750-b · Cited by 35 · cited 3× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundConcurrent milk ingestion decreases absorption of levothyroxine
Chon, D. A., Reisman, T., Weinreb, J. E., Hershman, J. M., & Leung, A. M. (2018) · Thyroid · doi:10.1089/thy.2017.0428 · Cited by 34 · cited 2× · see citing works
“…and L ‐ T4 intake by 1 h monitor thyroid parameters more frequently, adjust L ‐ T4 doses when needed Cow milk non ‐ randomized cross ‐ over study [59] probable adsorption of L ‐ T4 on casein impaired bioavailability of L ‐ T4 cannot be made due to the insufficient evidence Coffee (espresso, drip…”
BackgroundMethodSkelin, M., Lucijanić, T., Liberati-Čizmek, A.-M., Klobučar, S. M., Lucijanić, M., Jakupović, L., Bakula, M., Lončar, J. V., Marušić, S., Matić, T., et al. (2018) · Endocrine · doi:10.1007/s12020-018-1686-1 · Cited by 31 · cited 1× · see citing works
“In a randomized study conducted on 84 patients, Skelin et al. [25] compared three different timing regimens for L ‐ T4 administration: (1) 30 min before breakfast, (2) 1 h before lunch, and (3) at bedtime, more than 2 h after dinner.”
BackgroundBernareggi, A., Grata, E., Pinorini, M., & Conti, A. (2013) · Pharmaceutics · doi:10.3390/pharmaceutics5040621 · Cited by 30 · see citing works
Timing of breakfast does not influence therapeutic efficacy of liquid levothyroxine formulation
Morelli, S., Reboldi, G., Moretti, S., Menicali, E., Avenia, N., & Puxeddu, E. (2016) · Endocrine · doi:10.1007/s12020-015-0788-2 · Cited by 30 · cited 3× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundLaurent, I., Tang, S., Astère, M., Wang, K. R., Deng, S., Xiao, L., & Li, Q. F. (2018) · Endocrine · doi:10.1007/s12020-018-1574-8 · Cited by 30 · see citing works
Cappelli, C., Pirola, I., Gandossi, E., Cristiano, A., Daffini, L., Agosti, B., Casella, C., & Castellano, M. (2016) · International Journal of Endocrinology · doi:10.1155/2016/9043450 · Cited by 29 · cited 5× · see citing works
“We found only one study [47] investigating how meals affect absorption of L-T4 in a soft gel capsule formulation.”
BackgroundInfluentialIngestion of large amounts of papaya fruit and impaired effectiveness of levothyroxine therapy
Deiana, L., Marini, S., & Mariotti, S. (2012) · Endocrine Practice · doi:10.4158/ep11233.co · Cited by 28 · cited 3× · see citing works
“Deiana et al. [72] reported a case of a 37 ‐ year ‐ old patient after thyroidectomy, euthyroid on L ‐ T4 dose of 1.6 μ g/kg, with TSH levels from 1.2 to 1.9 mU/L.”
BackgroundInfluentialzu Schwabedissen, H. E. M., Ferreira, C., Schaefer, A. M., Oufir, M., Seibert, I., Hamburger, M. O., & Tirona, R. G. (2018) · Molecular Pharmacology · doi:10.1124/mol.117.111161 · Cited by 28 · cited 1× · see citing works
“Meyer et al. [70] found that thyroid hormones upregulate OATP2B1 expression, thus, hypothyroidism may influence juice ‐”
BackgroundPang, X., Pu, T., Xu, L., & Sun, R. (2020) · Clinical Endocrinology · doi:10.1111/cen.14172 · Cited by 26 · see citing works
Quantifying Amount of Adsorption of Levothyroxine by Percutaneous Endoscopic Gastrostomy Tubes
Manessis, A., Lascher, S., Bukberg, P. R., Darmody, T., Yen, V., Sadek, S., & Young, I. S. (2008) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607108314770 · Cited by 24 · cited 1× · see citing works
“Manessi et al. [103] discovered that L ‐ T4, when combined with EN, may adsorb to enteral feeding tubes.”
BackgroundClinical Relevancy of the Levothyroxine–Continuous Enteral Nutrition Interaction
Dickerson, R. N., Maish, G. O., Minard, G., & Brown, R. O. (2010) · Nutrition in Clinical Practice · doi:10.1177/0884533610385701 · Cited by 23 · cited 2× · see citing works
“[102] examined 13 patients with hypothyroidism.”
BackgroundInteraction between levothyroxine and calcium carbonate.
Mazokopakis, E. E., Giannakopoulos, T. G., & Starakis, I. (2008) · PubMed Central · Cited by 22 · see citing works
Pirola, I., Gandossi, E., Brancato, D., Marini, F., Cristiano, A., Delbarba, A., Agosti, B., Castellano, M., & Cappelli, C. (2018) · Journal of Endocrinological Investigation · doi:10.1007/s40618-018-0867-3 · Cited by 21 · cited 2× · see citing works
“[43] 761, hypothyroid 75 liquid form patient’s usual breakfast no significant changes in TSH levels Cappelli et al.”
BackgroundResultTrimboli, P., Virili, C., Centanni, M., & Giovanella, L. (2018) · Frontiers in Endocrinology · doi:10.3389/fendo.2018.00118 · Cited by 21 · cited 1× · see citing works
“This formulation, when compared to the tablets, can improve TSH levels both in patients with gastric diseases ( H. pylori infection, chronic gastritis, etc.) and with no proven malabsorption [22,23].”
BackgroundFerrous Fumarate-Induced Malabsorption Of Thyroxine
Leger, C. S., & Ooi, T. C. (1999) · The Endocrinologist · doi:10.1097/00019616-199911000-00011 · Cited by 18 · cited 3× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundCalcium Carbonate–Induced Hypothyroidism
Butner, L. E., Fulco, P. P., & Feldman, G. (2000) · Annals of Internal Medicine · doi:10.7326/0003-4819-132-7-200004040-00026 · Cited by 17 · see citing works
Antúnez, P., & Licht, S. (2011) · Revista Argentina de Endocrinología y Metabolismo · Cited by 15 · see citing works
Paśko, P., Rodacki, T., Domagała-Rodacka, R., & Owczarek, D. (2016) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2016.08.021 · Cited by 15 · cited 1× · see citing works
“Heuberger [106] and Pa ś ko et al. [107] provided a few reasons for that, such as undefined framework study, hardly available appropriate samples, or measurement difficulties.”
BackgroundPersiani, S., Sala, F., Manzotti, C., Colovic, M., Zangarini, M., Donazzolo, Y., Barbetta, B., Vitalini, C., Giacovelli, G., Benvenuti, C., et al. (2015) · Drug Research · doi:10.1055/s-0035-1555784 · Cited by 14 · see citing works
Identifying predictors of prolonged levothyroxine dose adjustment after thyroidectomy
Atruktsang, T. S., Zaborek, N. A., Imbus, J. R., Long, K., Pitt, S. C., Sippel, R. S., & Schneider, D. F. (2019) · Journal of Surgical Research · doi:10.1016/j.jss.2019.03.049 · Cited by 13 · cited 3× · see citing works
“…changing formulation from tablets to oral liquid form/gel capsules monitor thyroid parameters more frequently Aluminium (hydroxide) case reports [93,94], uncontrolled clinical study [75] unspecific adsorption of L ‐ T4, creating insoluble or sparingly soluble complexes in the intestine…”
BackgroundInfluentialMarina, M., Ceda, G. P., Aloe, R., Gnocchi, C., & Ceresini, G. (2016) · Acta bio-medica dell'Ateneo parmense/Acta biomedica · Cited by 12 · see citing works
Morini, E., Catalano, A., Lasco, A., Morabito, N., & Benvenga, S. (2019) · Endocrine · doi:10.1007/s12020-018-1798-7 · Cited by 12 · cited 2× · see citing works
“Morini et al. [86] performed a cohort study on a group of 50 postmenopausal, hypothyroid women.”
BackgroundDose administration time from before breakfast to before dinner affect thyroid hormone levels?
Ala, S., Akha, O., Kashi, Z., Asgari, H., Bahar, A., & Sasanpour, N. (2015) · PubMed Central · Cited by 11 · see citing works
Seechurn, S. B., Sharma, S., & Oyibo, S. O. (2012) · Open Journal of Endocrine and Metabolic Diseases · doi:10.4236/ojemd.2012.23005 · Cited by 11 · cited 2× · see citing works
“• low level of evidence: most studies are single case reports, case series, cohort studies (mainly retrospective), clinical studies without control groups (see Figure 1 and Table 2); • small number of patients in experimental studies: ≤10 participants [36,50,59,61,62,64, 75,79,80,85,87,98]; • presence of older studies…”
BackgroundPrevalence and clinical significance of interactions drug-enteral nutrition in Intensive Care Units
Reis, A. M. M., Carvalho, R. E. F. L. D., Faria, L. M. P. D., Oliveira, R. C. D., Zago, K. S. D. A., Cavelagna, M. F., Silva, A. G., Luis Neto, M., & Cassiani, S. H. D. B. (2014) · Revista Brasileira de Enfermagem · doi:10.5935/0034-7167.20140011 · Cited by 10 · cited 1× · see citing works
“Reis et al. [101] conducted a multicenter study in Intensive Care Units of seven teaching hospitals in Brazil to assess the prevalence of drug ‐ enteral nutrition (EN) interactions.”
BackgroundHypothyroïdie secondaire à une interaction médicamenteuse entre lévothyroxine et sels de fer
Fiaux, E., Kadri, K., Levasseur, C., Guillou, C. L., & Chassagne, P. (2010) · La Revue de Médecine Interne · doi:10.1016/j.revmed.2009.09.038 · Cited by 10 · see citing works
Drug administration adjustments for elderly patients with dysphagia: A case report
Mastroianni, P. D. C., & Forgerini, M. (2018) · Dementia & Neuropsychologia · doi:10.1590/1980-57642018dn12-010015 · Cited by 10 · see citing works
Malabsorption of L-T4 due to drip coffee: a case report using predictors of causation
Wegrzyn, N. M. (2016) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2016.02.016 · Cited by 9 · cited 3× · see citing works
“2 per kg Tablets espresso and barley coffee failure to normalize TSH levels Węgrzyn [63] 1, hypothyroid 175 Tablets drip coffee clinical signs of hypothyroidism (TSH level—8.”
BackgroundCongenital C2 (Type I) Deficiency Associated with Common Variable Immunodeficiency
Soto, M. E., Cordera, F., & Reyes, P. A. (2000) · Annals of Internal Medicine · doi:10.7326/0003-4819-132-7-200004040-00030 · Cited by 7 · see citing works
Counseling patients receiving levothyroxine (L-T4) and calcium carbonate.
Mazokopakis, E. E. (2006) · PubMed · Cited by 7 · see citing works
Self Medication Practices among Patients taking Levothyroxine
(2004) · The Internet Journal of Advanced Nursing Practice · doi:10.5580/22a8 · Cited by 6 · cited 1× · see citing works
“The study performed by Michel et al. [4] also revealed the patients’ inadequate knowledge on L ‐ T4 proper administration schedules.”
MethodCappelli, C., Pirola, I., & Castellano, M. (2020) · Case Reports in Endocrinology · doi:10.1155/2020/8858887 · Cited by 5 · cited 2× · see citing works
“[46] 1, hypothyroid 75 liquid form Lunch no significant changes in thyroid hormonal profiles”
BackgroundThyroxine in Goiter,H. pyloriInfection, and Gastritis
Dietrich, J. W., & Boehm, B. O. (2006) · New England Journal of Medicine · doi:10.1056/nejmc061447 · Cited by 3 · see citing works
The absorption of liquid levo-thyroxine is not significantly impaired by food intake.
Luca, F. D. (2016) · Acta bio-medica dell'Ateneo parmense/Acta biomedica · Cited by 2 · see citing works
Tešić, D., Stokić, E., Medic/Stojanoska, M., Mitrović, M., Tomić-Naglić, D., Ičin, T., Bajkin, I. A., Dejanović, B., & Tomić, M. (2018) · Endocrine Abstracts · doi:10.1530/endoabs.56.p996 · Cited by 2 · cited 2× · see citing works
“[71] 1, hypothyroid 200–700 Tablets juice and mint tea ↑ TSH level (> 100 mU/L), ↓ fT4 level (5.”
Background
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Optimal thyroid hormone replacement
Jonklaas, J. (2022) · Endocrine Reviews · doi:10.1210/endrev/bnab031 · Cited by 89 · see citing works
Centanni, M., Duntas, L., Feldt-Rasmussen, U., Koehrle, J., Peeters, R. P., Razvi, S., Trimboli, P., & Virili, C. (2025) · European Thyroid Journal · doi:10.1530/etj-25-0123 · Cited by 38 · see citing works
“Some types of foods and dietary supplements have been reported to reduce LT4 absorption, including soy, coffee, calcium, and grapefruit (14, 46) (Table 1).”
Stanojević-Ristić, Z., Mrkić, I., Ćorac, A., Dejanović, M., Mitic, R., Vitković, L., Rašić, J., Valjarević, D., & Valjarević, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19074290 · Cited by 33 · see citing works
Medications and Food Interfering with the Bioavailability of Levothyroxine: A Systematic Review
Liu, H., Lu, M., Hu, J., Fu, G., Feng, Q., Sun, S., & Chen, C. (2023) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s414460 · Cited by 29 · see citing works
“A similar systematic review by Wiesner et al was published in 2021.(144) A number of 63 studies were included in the qualitative synthesis.”
MethodChiba, T., & Tanemura, N. (2022) · Nutrients · doi:10.3390/nu14194114 · Cited by 26 · see citing works
Association between the Systemic Immune-Inflammation Index and Thyroid Function in U.S. Adults
Hu, X., Liang, Y.-C., Zhang, H.-H., Li, H.-L., & Liu, D. (2023) · Mediators of Inflammation · doi:10.1155/2023/5831858 · Cited by 26 · see citing works
“T3 and T4 secreted into the circulation are tightly bound to plasma proteins, a small proportion of these that are biologically active are known as free triiodothyronine (FT3) and free thyroxine (FT4), respectively [2].”
BackgroundWiesner, A., Szuta, M., Galanty, A., & Paśko, P. (2021) · Foods · doi:10.3390/foods10040720 · Cited by 26 · see citing works
“underestimate the impact of food and dosing regimen on drugs effectiveness [7].”
BackgroundEffect of coffee consumption on thyroid function: NHANES 2007-2012 and Mendelian randomization
Zhao, G., Wang, Z., Ji, J., & Cui, R. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1188547 · Cited by 24 · see citing works
A Survey of Knowledge About the Interaction Between Food and Drugs Among the Syrian Population
Zanboua, R. Z., & Abbood, A. (2024) · International Journal of Advanced Pharmaceutical Sciences and Research · doi:10.54105/ijapsr.d4044.04040624 · Cited by 23 · see citing works
Wiesner, A., Zwolinska-Wcislo, M. M., & Paśko, P. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18073527 · Cited by 23 · see citing works
“We recognized several limitations of the presented studies, similar to our previous investigation in this area [92,93] listed below:”
ResultWiesner, A., Skrońska, M., Gawlik, G., Marcinkowska, M., Zagrodzki, P., & Paśko, P. (2022) · AIDS and Behavior · doi:10.1007/s10461-022-03880-6 · Cited by 22 · see citing works
Zhao, Y., Zhou, M., Shang, Y., Dou, M., Gao, S., Yang, H. T., & Zhang, F. (2024) · Diabetes and Vascular Disease Research · doi:10.1177/14791641241228156 · Cited by 17 · see citing works
Wiesner, A., Zagrodzki, P., Gawalska, A., & Paśko, P. (2024) · Clinical Pharmacokinetics · doi:10.1007/s40262-024-01377-0 · Cited by 15 · see citing works
“The type of meal (e.g., high-fat, low-fat, high-protein) and the quantitative composition of the meal (e.g., caloric load, fat content) often influenced the food effect for many previously studied drugs [28, 29].”
BackgroundWiesner, A., Zagrodzki, P., Gawalska, A., & Paśko, P. (2024) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkae315 · Cited by 15 · see citing works
Ducharme, M., Scarsi, C., Bettazzi, E., Mautone, G., Lewis, Y., & Celi, F. S. (2022) · Thyroid · doi:10.1089/thy.2021.0604 · Cited by 13 · see citing works
“Recent studies have suggested that the effect of food on LT4 could be minimized by replacing tablets with an oral solution (32).”
BackgroundRefractory hypothyroidism: unraveling the complexities of diagnosis and management
Quiroz-Aldave, J. E., Concepción-Zavaleta, M. J., Durand-Vásquez, M. D. C., Concepción-Urteaga, L. A., Gamarra-Osorio, E. R., Suárez-Rojas, J., Rafael-Robles, L. D. P., Paz-Ibarra, J., & Román-González, A. (2023) · Endocrine Practice · doi:10.1016/j.eprac.2023.09.003 · Cited by 14 · see citing works
Dietary Patterns and Hypothyroidism in U.S. Adult Population
Alkhatib, D. H., Shi, Z., & Ganji, V. (2024) · Nutrients · doi:10.3390/nu16030382 · Cited by 16 · see citing works
Stagi, S., Municchi, G., Ferrari, M., & Wasniewska, M. G. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.859487 · Cited by 14 · see citing works
“It is important to inform parents and caregivers about the possible interference of drugs and supplements and the potential damage they can cause in patients who are dependent on exogenous l-T4 (100).”
BackgroundInfluentialAlhubail, S., Alharthi, M. S., Alsayyah, F., & Younis, N. S. (2023) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s419544 · Cited by 12 · see citing works
“15,16 Healthcare providers play an important role in averting DFIs 17 via recognizing as well as offering sufficient information regarding probable DFIs.”
BackgroundWiesner, A., Zagrodzki, P., & Paśko, P. (2024) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkae028 · Cited by 14 · see citing works
“180,186 That is why, in our review, we collected available data regarding food, and, where applicable, we used the type of meal as a grouping variable in subgroup analyses.”
MethodComputer-Assisted Levothyroxine Dose Selection for the Treatment of Postoperative Hypothyroidism
Barrio, M. J., Raeburn, C. D., McIntyre, R., Albuja-Cruz, M. B., Haugen, B. R., & Pozdeyev, N. V. (2023) · Thyroid · doi:10.1089/thy.2023.0033 · Cited by 11 · see citing works
Kumarathunga, P. A. D. M., Kalupahana, N. S., & Antonypillai, C. N. (2021) · Endocrinology, Diabetes & Metabolism Case Reports · doi:10.1530/edm-21-0070 · Cited by 9 · see citing works
Ali, Z. H., Abdulridha, M. K., & Alzajaji, Q. B. (2024) · Journal of Medicine and Life · doi:10.25122/jml-2023-0387 · Cited by 7 · see citing works
“This is supported by Ma-zokopakis et al ., who found that only 8.4% of 153 individuals took calcium carbonate at least 4 hours apart from LT4 [39].”
MethodInfluentialZhu, Y., Zhu, B., & Jin, P. (2025) · Risk Management and Healthcare Policy · doi:10.2147/rmhp.s500557 · Cited by 6 · see citing works
“For 27–31 It is also important to note that many medications have not been tested for oral absorption and bioavailability when administered through a feeding tube, and they may exhibit physico-chemical incompatibilities with the materials used in the tube.”
Acampora, L., Restolfer, F., Pierro, P. D., Masulli, M., Dentice, M., Sarnelli, G., & Cicatiello, A. G. (2026) · Frontiers in Physiology · doi:10.3389/fphys.2026.1753136 · Cited by 6 · see citing works
“Absorption efficiency is influenced by gastric pH, intestinal motility, mucosal surface area, and luminal composition (Wiesner et al., 2021; Liu et al., 2023).”
Decreased expression of ileal thyroid hormone transporters in a hypothyroid patient: a case report
Chung, C. W., Mo, E. Y., Jung, G. S., Kim, Y. H., Cho, S. W., Park, D. J., Bae, J. M., & Park, Y. J. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.664839 · Cited by 5 · see citing works
Bianchini, B. V., de Jesus, P. R., de Mello, R. G. B., Ziegelmann, P. K., Filion, K. B., & Pizzol, T. D. S. D. (2024) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2024.2313616 · Cited by 6 · see citing works
“This medicine has good intestinal absorption, although some agents and conditions can influence its absorption, such as foods, beverages, and other drugs [4,5].”
BackgroundThyroid hormone replacement therapy in dialysis/renal insufficiency patients
Zhao, X., Liu, F., Yuan, S., Wang, F., Li, C., Guo, C., & Zhao, J. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1540802 · Cited by 5 · see citing works
“L-T4 can non-speci fi cally adsorb onto dietary fi ber, leading to a decrease in its bioavailability (89).”
Mazeto, G. M. F. D. S., Sgarbi, J. A., Ramos, H. E., Villagelin, D., Nogueira, C. R., Vaisman, M., Graf, H., & de Carvalho, G. A. (2022) · Archives of Endocrinology and Metabolism · doi:10.20945/2359-3997000000545 · Cited by 7 · see citing works
Guglielmi, R., Mian, C., Novizio, R., Paoletta, A., Persichetti, A., Samperi, I., Scoppola, A., Bagnasco, M., Menis, E. D., Rimini, M. L. D., et al. (2025) · Journal of Endocrinological Investigation · doi:10.1007/s40618-025-02652-y · Cited by 6 · see citing works
Willems, J. I. A., van Twist, D. J. L., Helmich, F., Sluiter, T., Medici, M., Peeters, R. P., & van Wijngaarden, R. F. A. T.-D. L. (2025) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaf686 · Cited by 4 · see citing works
Wiesner, A., Zagrodzki, P., & Paśko, P. (2025) · Clinical Pharmacokinetics · doi:10.1007/s40262-025-01511-6 · Cited by 4 · see citing works
“The type of meal (e.g., high-fat, high-protein, low-fat) and its quantitative composition (e.g., fat content, caloric load) may significantly influence the food effect for many drugs [39, 40].”
Li, J., Zhang, C., Mao, B., Liu, Q., Wang, Y., Yi, B., & Liu, Q. (2024) · PeerJ · doi:10.7717/peerj.16755 · Cited by 4 · see citing works
“Previous research ( Greger & Sutherland, 1997 ) has shown that a healthy person may accumulate 30 – 50 mg/kg of Al, with normal serum levels ranging from 1 – 3 m g/L ( Wiesner, Gajewska & Pa ś ko, 2021 ).”
BackgroundNutritional management of survivors of critical illness: The clinical pharmacists' role
Rosseel, Z., Wuyts, S. C. M., Desmedt, M., von Winckelmann, S., Waele, E. D., Ligneel, C., & Cortoos, P. (2025) · Clinical Nutrition Open Science · doi:10.1016/j.nutos.2025.06.002 · Cited by 3 · see citing works
Breakfast Habits in Patients Using Levothyroxine: Patient Experiences and Preferences
Willems, J. I. A., van Twist, D. J. L., Luu, I. H. Y., Bianchi, R., Peeters, R. P., & van Wijngaarden, R. F. A. T.-D. L. (2024) · Journal of the Endocrine Society · doi:10.1210/jendso/bvae180 · Cited by 3 · see citing works
Schiavo, L., Giosuè, A., Izzo, V., Piaz, F. D., Filippelli, A., & Pilone, V. (2021) · Obesity Surgery · doi:10.1007/s11695-021-05518-3 · Cited by 3 · see citing works
Gatta, E., Maltese, V., Cavadini, M., Anelli, V., Bambini, F., Buoso, C., Facondo, P., Pirola, I., Delbarba, A., & Cappelli, C. (2023) · Endocrine Practice · doi:10.1016/j.eprac.2023.08.009 · Cited by 2 · see citing works
Park, J.-H., Seo, S., Kim, S. W., & Kang, Y.-H. (2025) · Frontiers in Veterinary Science · doi:10.3389/fvets.2025.1544599 · Cited by 2 · see citing works
Effects of essential metals (iron, zinc, and copper) on thyroid diseases - a narrative review
Wei, H., Li, Z., Liu, Z., Wu, B., Li, R., Xu, M., Yang, X., Yin, J., Zhang, Y., & Liu, Y. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1786788 · Cited by 2 · see citing works
“This interaction occurs because iron salts can form insoluble complexes with the phenol, carboxylic acid, and amine functional groups of L-T4, thereby reducing the drug’s bioavailability (21).”
Mussel-inspired biphasic microneedle patch for long-acting hypothyroidism treatment
Zhang, W., Liu, H., Hou, J., Lei, K., Lei, J., Jin, Y., Chen, C., Huang, J., & Li, W. (2026) · Acta Pharmaceutica Sinica B · doi:10.1016/j.apsb.2026.04.012 · Cited by 2 · see citing works
“…before entering the bloodstream, which not only affects drug bioavailability due to a significant first-pass effect and rapid he-patic metabolism, but also renders LT 4 absorption susceptible to factors like gastrointestinal disorders 11,12 , food intake 13,14 , and concomitant medications 15,16 .”
Ossäre Bedeutung von Mineral- und Heilwässern: Physiologie und epidemiologische Evidenz
Ströhle, A., & Hahn, A. (2023) · Osteologie/Osteology · doi:10.1055/a-2171-7360 · Cited by 2 · see citing works
Dalugodage, S. S., Bowatte, G., Antonypillai, C., Rajapakse, S., & Tennakoon, T. M. I. U. K. (2024) · BMC Medical Genomics · doi:10.1186/s12920-024-01849-z · Cited by 2 · see citing works
“…products (soybeans, soy milk, tofu), foods high in fiber (bran flakes, fiber drinks, broccoli, nuts, whole grains), foods high in iodine (cod, plain yogurt), grape-fruit/grapefruit juice and coffee/tea with LT-4 may increase the serum TSH levels and may increase LT-4 dose requirements [20, 23].”
BackgroundWiesner, A., Zagrodzki, P., & Paśko, P. (2022) · Farmacja Polska · doi:10.32383/farmpol/157002 · Cited by 1 · see citing works
Optimizing Levothyroxine Replacement in Primary Care Practice
Gunasekaran, K., & Tan, N. C. (2024) · IntechOpen eBooks · doi:10.5772/intechopen.1005906 · Cited by 2 · see citing works
Bukić, J., Rušić, D., Turić, A., Leskur, D., Durdov, T., Božić, J., Kondža, M., Modun, D., & Perišin, A. Š. (2024) · Pharmacy · doi:10.3390/pharmacy12060172 · Cited by 1 · see citing works
Alabedi, R. F., Abdullah, W. H., & Alsaffar, H. (2025) · Medical Journal of Babylon · doi:10.4103/mjbl.mjbl_1222_23 · Cited by 1 · see citing works
Singh, R., & Tandon, A. (2025) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/ijem.ijem_525_24 · Cited by 1 · see citing works
“[11] Many factors affect the pharmacokinetics and dynamics of levothyroxine and have been identified for undertreatment and overtreatment with levothyroxine in hypothyroid patients.”
Schilddrüse und Mikronährstoffe – beyond deficiency or beyond evidence?
Wallner, M., & Rudzite, D. (2026) · Journal für Endokrinologie Diabetologie und Stoffwechsel · doi:10.1007/s41969-026-00308-7 · Cited by 1 · see citing works
Diagnóstico temprano y tratamiento de hipotiroidismo congénito
Quilligana, J. M. C., & Ortiz, R. A. M. (2023) · Ciencia Latina Revista Científica Multidisciplinar · doi:10.37811/cl_rcm.v7i2.6160 · Cited by 1 · see citing works
Simultaneous Intake of Liquid L-T4 Formulation and Iron Salt: Fact or Fiction?
Maltese, V. (2023) · Acta Endocrinologica (Bucharest) · doi:10.4183/aeb.2023.54 · Cited by 1 · see citing works
Momento de administración de levotiroxina en pacientes con hipotiroidismo
Kutner, R. (2023) · Evidencia actualizacion en la práctica ambulatoria · doi:10.51987/evidencia.v26i3.7052 · Cited by 1 · see citing works
Spinelli, C., Ghionzoli, M., Sahli, L. I., Visintainer, S., Guglielmo, C., Cordola, C., Lapi, S., Biagi, E., Pucci, A., Morganti, R., et al. (2024) · Cancers · doi:10.3390/cancers16112112 · Cited by 1 · see citing works
Thyroxine Replacement Therapy during Ramadan Fasting: A Narrative Review
Aljaberi, A. K., Alamoudi, R. M., Elsherbiny, T. M., Hafidh, K., Raza, S. A., & Beshyah, S. (2024) · Journal of Diabetes and Endocrine Practice · doi:10.1055/s-0044-1791485 · Cited by 1 · see citing works
Ayhan, Y. E., Bektay, M. Y., Yavuz, D. G., & Sancar, M. (2025) · BMC Endocrine Disorders · doi:10.1186/s12902-025-01914-3 · Cited by 1 · see citing works
“Otherwise, LT4 absorption may decrease [34, 35].”
Comment on biotin-induced thyroid stimulating hormone aberrations in the setting of immunotherapy
Ghazal, K., & Piketty, M. (2021) · Journal of Oncology Pharmacy Practice · doi:10.1177/10781552211029706 · Cited by 1 · see citing works
“Another possibility would be an interaction between dietary supplements and Levothyroxin absorption.(13) In any case, a biotin-induced analytical interference seems unlikely in the monitoring reported.”
BackgroundLi, J., Zhang, C., Yi, B., Mao, B., Liu, Q., Wang, Y., Dai, Z., You, C., & Liu, Q. (2022) · Research Square · doi:10.21203/rs.3.rs-1656321/v1 · Cited by 1 · see citing works
Díez, M. A. J., Jaén, Á., & Alonso, M. A. J. (2022) · FarmaJournal · doi:10.14201/fj2022712938
Li, J., Zhang, C., Mao, B., Liu, Q., Wang, Y., Dai, Z., Yi, B., & Liu, Q. (2022) · Research Square · doi:10.21203/rs.3.rs-2062875/v1
Herb-Herb and Food-Drug Interactions
Hemaiswarya, S., Prabhakar, P. K., & Doble, M. (2022) · Springer eBooks · doi:10.1007/978-981-19-5125-1_3
Functional thyroid disorders in the pharmacy setting: How can we help our patients?
Pecikoza, U. B. (2022) · Arhiv za farmaciju · doi:10.5937/arhfarm72-39858
Arumugavignesh, M., Alexander, J. P., Abdulla, M. S., Sreekumaran, A., & Palani, J. L. (2023) · Indian Journal of Pharmacy Practice · doi:10.5530/097483261405
Ye, S., Davis, S. R., Ng, E., Warren, A. M., Szwarcbard, N., & Sztal‐Mazer, S. (2023) · Australian Journal of General Practice · doi:10.31128/ajgp-09-22-6561
Signorino, C., Municchi, G., Ferrari, M., & Stagi, S. (2023) · Journal of Clinical Research in Pediatric Endocrinology · doi:10.4274/jcrpe.galenos.2023.2023-9-12
“Proton-pump inhibitors, aluminium-containing antacids, iron and calcium salts, herbal remedies and nutritional supplements may worsen L-T4 absorption, modifying gastric pH or binding with L-T4 to create insoluble complexes (2,7,8,9).”
Dynamic Tests in Clinical Endocrinology
Quarde, A. (2023) · Wiley eBooks · doi:10.1002/9781119863564.ch9
Levotiroxina, ¿por la mañana o más bien tarde?
Toledo, R. B., & Padilla, P. (2023) · Actualización en Medicina de Familia · doi:10.55783/amf.191107
戴, 晓. (2024) · Advances in Clinical Medicine · doi:10.12677/acm.2024.1451494
Guglielmi, R., Mian, C., Andreoli, C., Bagnasco, M., Boniardi, M., Menis, E. D., Rimini, M. L. D., Tina, D., Fiorentini, G., Locantore, P., et al. (2025) · L Endocrinologo · doi:10.1007/s40619-025-01601-4
Coffee Through the Prism of a Family Doctor’s Practice
Szczurek, W., Szyguła‐Jurkiewicz, B., & Jozwiak, J. J. (2025) · Springer eBooks · doi:10.1007/978-3-031-93459-9_36
Food-Drug Interactions: Navigating the Complex Relationship
Ewis, D. K., & El-Sayed, O. S. (2025) · Nutritional neurosciences · doi:10.1007/978-981-95-1983-5_14
Pharmacological Interactions of Levothyroxine in Multiple-Treated Patients
Marco, F. D., & Cusini, C. (2025) · Springer eBooks · doi:10.1007/978-3-032-01700-0_14
Die Rolle von Ballaststoffen bei der Gewichtsregulation
Skurk, T. (2025) · CME · doi:10.1007/s11298-025-4329-x
“Bei Schilddrüsenerkrankungen ist an eine verrin-gerte Resorption von Levothyroxin im Darm zu den-ken (30–60 Minuten Abstand vor einer ballaststoff-reichen Mahlzeit) [ 27 ].”
Zhang, Z., Xu, M.-X., Wang, N., Shen, R., Sun, J., Zha, M., & Wang, M. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1695902 · Cited by 1 · see citing works
Kaya, P., & Erden, S. (2026) · Supportive Care in Cancer · doi:10.1007/s00520-026-10533-0
“Medication errors are frequently reported after total thyroidectomy [1, 2, 10].”
Sylvestre, J., Byham-Gray, L. D., & Radler, D. R. (2026) · Dietetics · doi:10.3390/dietetics5020027
Wrońska, K., Szczuko, U., Szydłowska, I., Nawrocka-Rutkowska, J., Rudak, L., Kwiatkowska, L., Szukalska, I., & Szczuko, M. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27114864
“Food and certain beverages, including soy, coffee, dietary fiber, and papaya, as well as supplements such as iron and calcium, can significantly reduce L–T4 absorption [16].”
Medication–Meal Timing: An Underrecognized Determinant of Drug Efficacy and Safety
Faisal, H., & Lal, K. C. (2026) · INNOVAPATH · doi:10.63501/qb3ey096
“Certain medications, such as levothyroxine, are best taken on an empty stomach for maximum efficacy and absorption (4).”
Navigating the Complexities of Drug-Alcohol and Drug-Nutrient Interactions
Bhatia, S., Bharatiya, P., & Thareja, S. (2026) · BENTHAM SCIENCE PUBLISHERS eBooks · doi:10.2174/9798898814328126010010
Hypothyroidism Management: Beyond TSH: A Clinical Review
Mazza, A. D., & Dehn, B. (2026) · Clinical Journal for Nurse Practitioners in Women s Health · doi:10.1891/cjnpwh-2025-0063
Zambrano-Villacres, R., MONTENEGRO-ACOSTA, W. A., Veintimilla, D. R., Rodríguez-Larraburu, E., Espro, C., & Bressi, V. (2026) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2026.122220
Plant-derived therapies in Parkinson’s disease: a systematic review of clinical evidence
Sukmueng, N., Phokaewvarangkul, O., & Bhidayasiri, R. (2026) · Journal of Neural Transmission · doi:10.1007/s00702-026-03239-4
From meal to medicine: exploring the roots and consequences of drug-food effects
Löbenberg, R., Kabalan, J., Macfarlane, B., Djebbouri, S., Daunoras, S., Mougarbel, T., Qeshanna, M., Pham, P., Davies, N. M., Bou‐Chacra, N. A., et al. (2026) · Journal of Pharmaceutical Investigation · doi:10.1007/s40005-026-00825-2
Processing technologies for safe production of beverages
Areti, H. A., Adugna, A., Gudeta, R. L., Negewo, D. L., & Prasad, N. V. V. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-36536-2.00009-0
Hypothyroidism in patients treated with immune checkpoint inhibitors
Laghmouch, N., Meeusen, I., & Twickler, T. B. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-30261-9.00022-x
Abdel-Salam, E. T., Salam, M. A. E., Anwar, Z. M., Mostafa, H. M., Ibrahim, A. Z., Elsalam, M., & El‐Magid, M. A. (2026) · Luminescence · doi:10.1002/bio.70625
“Metal ions encountered in supplements and antacids (Fe 3+ , Al 3+ , and Ca 2+ ) may participate in ternary or higher order systems with drugs and albumin, although the observed response depends on solution conditions, speciation, and coordination chemistry [33–36].”
From Feeding Difficulties to Nutritional Risk in Children with Down Syndrome
Ravančić, M. E., Obradović, V., & Škrabal, S. (2026) · Nutrients · doi:10.3390/nu18193295
“…consistent medication administration in relation to meals and appropriate temporal separation from iron and calcium supplements or enteral nutrition, in accordance with the prescriber’s instructions and follow-up laboratory results, because these exposures may reduce levothyroxine absorption [87].”
- Authors
- Wiesner, A., Gajewska, D., & Paśko, P.
- Affiliations
- Jagiellonian University (PL)
- Warsaw University of Life Sciences (PL)
- Corresponding author
- Paśko, Paweł
- Venue
- Pharmaceuticals
- Publisher
- MDPI AG
- Published
- 2021-03-02
- Volume
- 14
- Issue
- 3
- Pages
- 206
- ISSN
- 1424-8247 (ISSN-L)
- PMC
- PMC8002057
- OpenAlex
- W3134264366
- Cited by
- 85
- References
- 104
- Citations by year
- 2026: 18 · 2025: 16 · 2024: 16 · 2023: 16 · 2022: 12 · 2021: 7
- FWCI
- 1.96
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Pharmaceuticals (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Homo Politicus (Academy of Humanities and Economics in Lodz) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Polish Ministry of Higher Education (SONP/SP/461418/2020)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Keywords
- levothyroxine, food-drug interactions, dietary supplements, hypothyroidism, pharmacokinetics, drug absorption, coffee, calcium supplements, iron supplements, soy products, fibers, enteral nutrition, vitamin C, papaya
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