An interesting little paper. Rather limited but possibly worth a few minutes of reading.
Novel thyroxine formulations: a further step toward precision medicine
• Authors
• Camilla Virili
• Pierpaolo Trimboli
• Marco Centanni
• Camilla Virili
First Online: 15 October 2019
Abstract
Levothyroxine (T4) is a critical-dose drug, because little variations in the blood concentration may cause treatment failure as well as iatrogenic thyrotoxicosis. Despite the dose response of this drug being more carefully titrated nowadays, several papers still report that a significant fraction of patients treated with levothyroxine demonstrate a TSH which is not on target. Moreover, some widespread gastrointestinal disorders as well as interfering drugs and foods may cause the “refractoriness” of a significant number of patients to an expected dose of thyroxine. The increasing awareness of the mechanisms interfering with the oral thyroid hormone bioavailability and the body of evidence regarding the complexity of treatment in certain classes of patients prompted pharmaceutical research to identify new hormonal formulations to optimize the performance of this drug. In this brief review, the progression of the scientific knowledge of novel T4 formulations use has been analyzed.
Keywords
Liquid levothyroxine Softgel thyroxine Thyroxine absorption Thyroxine malabsorption Drugs dissolution Gastrointestinal disorders
Full paper freely available here:
link.springer.com/article/1...
faykc
What Happens if I Take Thyroxine with Adrenal Problems?
VitD3 and medications that can reduce thyroid hormone absorption...
haven't read it all, but this leapt out at me! "a significant fraction of patients treated with levothyroxine demonstrate a TSH which is not on target. "
They still insist that TSH is the "Target"!!!
I very much agree about that - it was more the rest of the paper that had some interest.
Yes. It's just that one tends to notice the TSH brainwashing in even good research papers and articles!
I agree I’m peeved at this TSH business ruling our lives. Even my private Endo who prescribed me T3 has said a couple of time’s ‘well your TSH is not completely suppressed (it’s 0.003) so we’ll carry on’ Although it may be that he’s thinking of how he can justify himself if anyone cane asking. That’s what I’m hoping anyway. That it’s not him, it’s what others in his field will say.
I agree. I was very impressed with my endo until the end of the conversation when she said something about suppressed TSH and I said “but that’s to be expected on T3, isn’t it?” And she said “well, it’s not ideal, it’s bad for your bones. Problem is we just don’t know yet”.
I felt like saying “I’ll take the risk, thanks” which is exactly what I’ll say if the subject is raised again! 🙄
Interesting paper though, thanks helvella