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

Details

Title
7370 Review of the Literature, and Report of a Series of Patients with Lactose Intolerance and Levothyroxine Malabsorption in Treatment with Liquid L-T4
Author
Ferrari, Silvia Martina 1 ; Patrizio, Armando 2 ; Mazzi, Valeria 3 ; Ragusa, Francesca 3 ; Botrini, Chiara 3 ; Elia, Giusy 3 ; Balestri, Eugenia 3 ; Barozzi, Emilio 3 ; Rugani, Licia 3 ; Bracchitta, Fabiana 3 ; Stoppini, Giulio 3 ; Frenzilli, Giada 1 ; Baldini, Enke 4 ; Virili, Camilla 5 ; Benvenga, Salvatore 6 ; Fallahi, Poupak 7 ; Antonelli, Alessandro 3 

 University of Pisa, Department of Clinical and Experimental Medicine , Pisa , Italy 
 Azienda Ospedaliero-Universitaria Pisana, Department of Emergency Medicine , Pisa , Italy 
 University of Pisa, Department of Surgical, Medical and Molecular Pathology and Critical Area , Pisa , Italy 
 "Sapienza" University of Rome, Department of Experimental Medicine , Rome , Italy 
 ''Sapienza'' University of Rome, Department of Medico-Surgical Sciences and Biotechnologies , Rome , Italy 
 University of Messina,Department of Clinical and Experimental Medicine , Messina , Italy 
 University of Pisa, Department of Translational Research and New Technologies in Medicine and Surgery , Pisa , Italy 
Publication year
2024
Publication date
Oct-Nov 2024
Publisher
Oxford University Press
e-ISSN
24721972
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3170223818
Copyright
© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.