Levothyroxine pseudo-malabsorption: testing and treatment in the outpatient setting

Persistent elevation of thyroid stimulating hormone (TSH) is a common clinical problem in outpatient clinics treating patients with primary hypothyroidism. One challenge to practitioners involves predicaments where patients have an inadequate response to a seemingly appropriate dose of levothyroxine...

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Bibliographic Details
Main Authors: Grzegorz M. Rdzak, Laura M. Whitman, Silvio E. Inzucchi
Format: Article
Language:English
Published: SAGE Publishing 2018-07-01
Series:Therapeutic Advances in Endocrinology and Metabolism
Online Access:https://doi.org/10.1177/2042018818771433
Description
Summary:Persistent elevation of thyroid stimulating hormone (TSH) is a common clinical problem in outpatient clinics treating patients with primary hypothyroidism. One challenge to practitioners involves predicaments where patients have an inadequate response to a seemingly appropriate dose of levothyroxine (L-T4). A patient’s self-assessed compliance to hormone replacement therapy or verification refill history at the patient’s pharmacy might not be a reliable form of confirmation of non-adherence to the drug by the patient, which has been referred to as “L-T4 pseudo-malabsorption.” A fast and inexpensive tool to rule out true LT4 malabsorption and thereby properly diagnosing and ultimately successfully treat LT4 pseudo-malabsorption is available in the outpatient setting. This allows clinicians to identify which patients for individual support in adhering to their prescribed therapy and may also reduce unnecessary referrals for sub-specialty care by endocrinologists.
ISSN:2042-0188
2042-0196