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Endocrine

pp 1–4 | Cite as

Levothyroxine absorption test results in patients with TSH elevation resistant to treatment

  • Ilgin Yildirim SimsirEmail author
  • Utku Erdem Soyaltin
  • Ahmet Gokhan Ozgen
Original Article
  • 31 Downloads

Abstract

Introduction

Persistent elevation of thyroid-stimulating hormone (TSH) is common in endocrinology practice in patients undergoing replacement or suppression therapy with levothyroxine sodium (LT4). After examining the causes of this condition, LT4 absorption test is recommended. In this report, we wanted to share our results of LT4 absorption test in patients with elevated TSH levels.

Materials–methods

The files of patients who presented to our clinic between 2015 and 2018, whose TSH elevation continued despite high-dose LT4 therapy, and who underwent absorption test were reviewed retrospectively.

Results

Levothyroxine sodium absorption test was applied to five patients. Absorption test revealed LT4 malabsorption in two patients and pseudomalabsorption in the other three patients.

Discussion

When all published pseudomalabsorption cases were considered, it has been stated that at least 2.5 times increase in basal fT4 level may exclude malabsorption. The formula we used has been implemented by Cleveland Clinic since 2014.

Conclusion

In cases where TSH normalization is not achieved despite high doses of LT4 therapy, LT4 absorption test is an easy test for administration and interpretation and prevents unnecessary medical treatments and examinations.

Keywords

Levothyroxine Malabsorption Pseudomalabsorption 

Notes

Author contributions

I.Y.S. and U.E.S. wrote the manuscript. I.Y.S. and A.G.O. reviewed/edited the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Endocrinology and Metabolism DisordersEge University Medical FacultyIzmirTurkey

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