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Sucralfate and the Absorption of L-Thyroxine
Abstract
Letters15 July 1994Sucralfate and the Absorption of L-ThyroxineJohn A. Campbell, MD, Barbara A. Schmidt, MD, and John P. Bantle, MDJohn A. Campbell, MDSearch for more papers by this author, Barbara A. Schmidt, MDSearch for more papers by this author, and John P. Bantle, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-2-199407150-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Although an in vitro study showed binding of l-thyroxine by sucralfate [1], a later study showed that sucralfate did not interfere with in vivo absorption of replacement l-thyroxine in patients with hypothyroidism [2]. After encountering such a patient receiving replacement l-thyroxine who experienced a decrease in serum thyroxine (T4) index and a dramatic increase in serum thyrotropin after starting treatment with sucralfate, we studied the effect of sucralfate on l-thyroxine absorption.After obtaining informed consent and baseline tests, nine patients with primary hypothyroidism were randomly assigned to treatment with sucralfate, 1 g 4 times daily or placebo, ...References1. Havrankova J, Lahaie R. Levothyroxine binding by sucralfate. Ann Intern Med. 1992; 117:445-4. Google Scholar2. Khan F, Jeanniton E, Renedo M. Does sucralfate impede levothyroxine therapy? Ann Intern Med. 1993; 118:317. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byGastrointestinal Malabsorption of ThyroxineConcurrent Milk Ingestion Decreases Absorption of LevothyroxineFactors Affecting Gastrointestinal Absorption of Levothyroxine: A ReviewGuidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone ReplacementInfluence of Drugs on Thyroid Function TestsDisorders of the Thyroid GlandConditions and drugs interfering with thyroxine absorptionInterference with the absorption of levothyroxineDrugs and Thyroid Function 15 July 1994Volume 121, Issue 2Page: 152KeywordsHypothyroidismPatientsThyroidThyroid-stimulating hormoneThyroxine ePublished: 15 August 2000 Issue Published: 15 July 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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“Only two of these medications have been studied in a cross-over study design of chronic therapy (132,145), with two other studies also conducted prospectively (140,143).”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [145]
In the citing paper
“A blinded cross-over study of nine patients taking LT4 failed to show a statistically significant difference in TSH while patients were taking either placebo or sucralfate in addition to their LT4, although the study may have been underpowered and the mean serum TSH values for the placebo and sucralfate groups were 2.69 and 4.63 mIU/L, respectively (145).”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [145]
In the citing paper
“although the study may have been underpowered”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [145]
In the citing paper
“Studies of sucralfate are consistent with impaired absorption (144,145).”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [145]
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Jonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., Cooper, D. S., Kim, B. W., Peeters, R. P., Rosenthal, M. S., et al. (2014) · Thyroid® · doi:10.1089/thy.2014.0028 · Cited by 1,928
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
Gastrointestinal 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
Factors Affecting Gastrointestinal Absorption of Levothyroxine: A Review
Skelin, M., Lucijanić, T., Amidžić Klarić, D., Rešić, A., Bakula, M., Liberati-Čizmek, A.-M., Gharib, H., & Rahelić, D. (2017) · Clinical Therapeutics · doi:10.1016/j.clinthera.2017.01.005 · Cited by 133
Concurrent 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
Metadata
- Authors
- Campbell, J. A., Schmidt, B. A., & Bantle, J. P.
- Affiliations
- University of Minnesota, Duluth (US)
- ORCID
- Schmidt, Barbara A.
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 1994-07-15
- Volume
- 121
- Issue
- 2
- Pages
- 152
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2054643199
- Cited by
- 14
- References
- 0
- Citations by year
- 2026: 1 · 2023: 1 · 2022: 1 · 2018: 2 · 2017: 1 · 2014: 1 · 2012: 1
- FWCI
- 0.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Drug Solubulity and Delivery Systems
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- sucralfate, levothyroxine, drug-drug interactions, primary hypothyroidism, thyroid hormone replacement, serum thyroxine, thyroid-stimulating hormone, gastrointestinal malabsorption, antacids, drug interactions
- MeSH terms
- Adult, Double-Blind Method, Humans, Hypothyroidism, Middle Aged, Sucralfate, Thyroxine
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