Daily requirement of softgel thyroxine is independent from gastric juice pH

• DOI: 10.3389/fendo.2022.1002583
• Publication Date: 2022-09-26T09:36:45Z
• Authors: Camilla Virili; Silvia Capriello; Ilaria Stramazzo; Nunzia Brusca; Maria Giulia Sant...; Lucilla Gargano; Maria Flavia Baga...; Giovanni Bruno; Carola Severi; Marco Centanni
• Keywords: Levothyroxine

Softgel levothyroxine (LT4) preparation showed a better in vitro dissolution profile at increasing pH as compared to tablet LT4 preparation. Clinical studies suggested performance of softgel patients with gastric disorders but whether this finding is related juice variation vivo not known.Twenty-eight hypothyroid (24F/4M; median age=50 treated (median dose= 1.65 µg/kg/day) and stable thyroid stimulating hormone (TSH) values on target (<0.8-2.5> mU/l) have been shifted The dose has titrated obtain similar individual serum TSH value. All subjects followed specific treatment schedule, taking fasting condition then abstaining from eating or drinking for least 1 hour. Owing the presence long-lasting dyspepsia already known disorders, all underwent endoscopy, upon informed consent. Gastric collected during endoscopy measure pH. Then we plotted obtained vivo, before after switch tablet/softgel patients.Upon preparation, therapeutic was very slightly reduced (-6%) whole sample. However, variations revealed existence two populations, one without any reduction (A) other showing >20% (B). Upon matching actual pH, normal (A: n=17; 14F/3M, 1.52) no lower requirement. Instead, among acid production (B: n=11; 10F/1M, 5.02) vast majority (10/11; 91%, p<0.0001) benefited = -23%, p<0.0001). Interestingly, correlated value (Spearman's ρ =0.6409; p 0.0002) while independent =1.952; 0.3194).These findings provide evidence that humans may represent significant option increased requirement, owed impairing acidic output.