International Journal of Endocrinology and Metabolism

Published by: Kowsar

Rapid Levothyroxine Absorption Testing: A Case Series of Nonadherent Patients

Mamtha Balla 1 , Ram M. Jhingan 2 and Daniel J. Rubin 3 , *
Authors Information
1 Abington Memorial Hospital, Abington, USA
2 Einstein Medical Center Montgomery, East Norriton, USA
3 School of Medicine, Temple University, Philadelphia, USA
Article information
  • International Journal of Endocrinology and Metabolism: October 01, 2015, 13 (4); e31051
  • Published Online: October 13, 2015
  • Article Type: Brief Report
  • Received: June 26, 2015
  • Revised: July 28, 2015
  • Accepted: August 22, 2015
  • DOI: 10.5812/ijem.31051

To Cite: Balla M, Jhingan R M, Rubin D J. Rapid Levothyroxine Absorption Testing: A Case Series of Nonadherent Patients, Int J Endocrinol Metab. 2015 ; 13(4):e31051. doi: 10.5812/ijem.31051.

Copyright © 2015, Research Institute For Endocrine Sciences and Iran Endocrine Society. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Patients and Methods
4. Results
5. Discussion
  • 1. Gaitonde DY, Rowley KD, Sweeney LB. Hypothyroidism: an update. Am Fam Physician. 2012; 86(3): 244-51[PubMed]
  • 2. Surks MI, Sievert R. Drugs and thyroid function. N Engl J Med. 1995; 333(25): 1688-94[DOI][PubMed]
  • 3. Ain KB, Refetoff S, Fein HG, Weintraub BD. Pseudomalabsorption of levothyroxine. JAMA. 1991; 266(15): 2118-20[PubMed]
  • 4. Mersebach H, Rasmussen AK, Kirkegaard L, Feldt-Rasmussen U. Intestinal adsorption of levothyroxine by antacids and laxatives: case stories and in vitro experiments. Pharmacol Toxicol. 1999; 84(3): 107-9[PubMed]
  • 5. Azizi F, Belur R, Albano J. Malabsorption of thyroid hormones after jejunoileal bypass for obesity. Ann Intern Med. 1979; 90(6): 941-2[PubMed]
  • 6. Eledrisi MS, Szymajda A, Alshanti M, Urban RJ. Noncompliance with medical treatment: pseudomalabsorption of levothyroxine. South Med J. 2001; 94(8): 833-6[PubMed]
  • 7. Lips DJ, van Reisen MT, Voigt V, Venekamp W. Diagnosis and treatment of levothyroxine pseudomalabsorption. Neth J Med. 2004; 62(4): 114-8[PubMed]
  • 8. Srinivas V, Oyibo SO. Levothyroxine pseudomalabsorption and thyroxine absorption testing with use of high-dose levothyroxine: case report and discussion. Endocr Pract. 2010; 16(6): 1012-5[DOI][PubMed]
  • 9. Sun GE, Pantalone KM, Faiman C, Gupta M, Olansky L, Hatipoglu B. The clinical utility of free thyroxine in oral levothyroxine absorption testing. Endocr Pract. 2014; 20(9): 925-9[DOI][PubMed]
  • 10. Vita R, Benvenga S. Tablet levothyroxine (L-T4) malabsorption induced by proton pump inhibitor; a problem that was solved by switching to L-T4 in soft gel capsule. Endocr Pract. 2014; 20(3)-41[DOI][PubMed]
  • 11. Livadariu E, Valdes-Socin H, Burlacu MC, Vulpoi C, Daly AF, Beckers A. Pseudomalabsorption of thyroid hormones: case report and review of the literature. Ann Endocrinol (Paris). 2007; 68(6): 460-3[DOI][PubMed]
  • 12. Ogawa D, Otsuka F, Mimura U, Ueno A, Hashimoto H, Kishida M, et al. Pseudomalabsorption of levothyroxine: a case report. Endocr J. 2000; 47(1): 45-50[PubMed]
  • 13. Walker JN, Shillo P, Ibbotson V, Vincent A, Karavitaki N, Weetman AP, et al. A thyroxine absorption test followed by weekly thyroxine administration: a method to assess non-adherence to treatment. Eur J Endocrinol. 2013; 168(6): 913-7[DOI][PubMed]
  • 14. Goichot B, Vinzio S, Luca F, Sirlin X, Sapin R, Schlienger JL. In vivo evidence for a direct ultra-fast negative feedback of thyroxine on TSH secretion in humans: a case of L-thyroxine pseudomalabsorption. Clin Endocrinol (Oxf). 2007; 67(6): 952-3[DOI][PubMed]
  • 15. Mandel SJ, Brent GA, Larsen PR. Levothyroxine therapy in patients with thyroid disease. Ann Intern Med. 1993; 119(6): 492-502[PubMed]
  • 16. Morris JC. How do you approach the problem of TSH elevation in a patient on high-dose thyroid hormone replacement? Clin Endocrinol (Oxf). 2009; 70(5): 671-3[DOI][PubMed]
  • 17. Liwanpo L, Hershman JM. Conditions and drugs interfering with thyroxine absorption. Best Pract Res Clin Endocrinol Metab. 2009; 23(6): 781-92[DOI][PubMed]
  • 18. Benvenga S, Bartolone L, Squadrito S, Lo Giudice F, Trimarchi F. Delayed intestinal absorption of levothyroxine. Thyroid. 1995; 5(4): 249-53[PubMed]
  • 19. Kubota S, Fukata S, Matsuzuka F, Kuma K, Miyauchi A. Successful management of a patient with pseudomalabsorption of levothyroxine. Int J Psychiatry Med. 2003; 33(2): 183-8[PubMed]
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