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Abstract
Disclosure: S. Ferrari: None. A. Patrizio: None. V. Mazzi: None. F. Ragusa: None. C. Botrini: None. G. Elia: None. E. Balestri: None. E. Barozzi: None. L. Rugani: None. F. Bracchitta: None. G. Stoppini: None. G. Frenzilli: None. E. Baldini: None. C. Virili: None. S. Benvenga: None. P. Fallahi: None. A. Antonelli: None.
Intolerance to lactose-containing foods is frequent, with a prevalence of 7-20% in Caucasians, and of 80-95% among Native Americans. Therefore, lactose intolerance (LI) issue needs to be taken in account in the management of hypothyroid patients needing large doses of levothyroxine (L-T4) (> 1.7-2 μg/kg/day) to achieve euthyroidism. Indeed, the absorption of oral T4 may be affected in patients with LI, by following a diet containing lactose, whereas it is resulted to be improved with a lactose-free diet. Lactose is often present as a supplementary ingredient in many commercially available drugs, as L-T4 preparations. In susceptible individuals, drugs containing lactose can cause LI symptoms, and lactose in L-T4 preparations could impair thyroxine absorption. Moreover, it has been shown that patients with LI requiring an increased dosage of L-T4 benefit from a treatment with a lactose-free L-T4 formulation. The lactose-free liquid L-T4 formulation is able to circumvent LI malabsorption leading to the normalization of thyroid-stimulating hormone (TSH) in patients with subclinical hypothyroidism, and long term stable TSH levels. Further studies will be needed to evaluate the liquid L-T4 formulation in larger numbers of patients with hypothyroidism and LI.
Presentation: 6/3/2024
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1 University of Pisa, Department of Clinical and Experimental Medicine , Pisa , Italy
2 Azienda Ospedaliero-Universitaria Pisana, Department of Emergency Medicine , Pisa , Italy
3 University of Pisa, Department of Surgical, Medical and Molecular Pathology and Critical Area , Pisa , Italy
4 "Sapienza" University of Rome, Department of Experimental Medicine , Rome , Italy
5 ''Sapienza'' University of Rome, Department of Medico-Surgical Sciences and Biotechnologies , Rome , Italy
6 University of Messina,Department of Clinical and Experimental Medicine , Messina , Italy
7 University of Pisa, Department of Translational Research and New Technologies in Medicine and Surgery , Pisa , Italy