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L. H. Fish, H. L. Schwartz, J. Cavanaugh, M. W. Steffes, J. P. Bantle and J. H. Oppenheimer, “Replacement Dose, Metabolism, and Bioavailability of Levothyroxine in the Treatment of Hypothyroidism. Role of Triiodothyronine in Pituitary Feedback in Humans,” The New England Journal of Medicine, Vol. 316, 1987, pp. 764-770.
doi:10.1056/NEJM198703263161302
has been cited by the following article:
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TITLE:
Administration of Levothyroxine 45 - 60 Minutes before Breakfast Improves Biochemical Availability as Evidenced by Reduced Thyrotropin Levels
AUTHORS:
Shivshankar Seechurn, Sanjeev Sharma, Samson Oyibo
KEYWORDS:
Levothyroxine; Thyrotropin; Bioavailability
JOURNAL NAME:
Open Journal of Endocrine and Metabolic Diseases,
Vol.2 No.3,
August
2,
2012
ABSTRACT: Introduction: Serum Thyrotropin (TSH) level is used to assess adequacy of levothyroxine dosing for patients with hypothyroidism. Some patients have raised TSH levels despite being on an adequate dose of levothyroxine (100 mcg/day - 200 mcg/day). Aim: To evaluated the effect of advising patients to take their levothyroxine 45 - 60 minutes before breakfast on raised serum TSH levels. Patients and Methods: Rather than increase the dose, patients with raised TSH levels were asked to take their levothyroxine at least 45 - 60 minutes before breakfast and other oral medications. Thyroid Function Tests were assessed at base line and repeated after two months. Results: Data from ten patients who presented between 2008 and 2010 were analyzed (9 females, 1 male): With median (IQR) age: 39 (33 - 49) years and duration of hypothyroidism: 6 (3 - 7.8) years. Median (IQR) levothyroxine dose was 175 (144 - 250) mcg, serum free-Thyroxine (free-T4): 13 (10.5 - 17.1) pmol/L and serum TSH: 12.63 (6.2 - 48.3) mIU/L. After two months all patients demonstrated biochemical improvement; a decrease in serum TSH to 3.15 (0.4 - 6.1) mIU/L accompanied by an increase in serum free-T4 to 17.7 (14.8 - 21.3) pmol/L. Both changes were statistically significant (p