ReviewEndocrine2020
Prevalence of gastrointestinal disorders having an impact on tablet levothyroxine absorption: should this formulation still be considered as the first-line therapy?
Review in Endocrine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- ETA guidelines for the use of levothyroxine sodium preparations in monotherapy to optimize the treatment of hypothyroidism.European thyroid journal · 2025Guideline
- Therapeutic efficacy and patient compliance of levothyroxine liquid and softgel formulations taken with meals: a systematic review.Endocrine · 2025Pooled it
- Comparison of tablet versus liquid ethanol-free Levothyroxine in thyroidectomised patients.Endocrine · 2025Article
- No Association Between Diet Quality, Nutritional Status, and Quality of Life in Women with Hashimoto's Thyroiditis-A Cross-Sectional Study.Nutrients · 2025Article
- Morning exercise affects the absorption of oral levothyroxine: a single center pilot study.Endocrine · 2024Article
- Consequences of undertreatment of hypothyroidism.Endocrine · 2024Review
- Analysis of dose-TSH response effect of levothyroxine soft-gel formulation.Frontiers in endocrinology · 2024Article
- Article
- Changes in Drug Clinical Trials of Thyroid Diseases in China, 2009-2022.Drug design, development and therapy · 2023Article
- Pharmacokinetics and Clinical Implications of Two Non-Tablet Oral Formulations of L-Thyroxine in Patients with Hypothyroidism.Journal of clinical medicine · 2022Review
- Factors influencing the levothyroxine dose in the hormone replacement therapy of primary hypothyroidism in adults.Reviews in endocrine & metabolic disorders · 2022Review
- Article
- Article
- Daily requirement of softgel thyroxine is independent from gastric juice pH.Frontiers in endocrinology · 2022Article
- Evaluation of Bedtime vs. Morning Levothyroxine Intake to Control Hypothyroidism in Older Patients: A Pragmatic Crossover Randomized Clinical Trial.Frontiers in medicine · 2022Article
- An Overview on Different L-Thyroxine (l-TFrontiers in endocrinology · 2022Review
- Oral drug dosing following bariatric surgery: General concepts and specific dosing advice.British journal of clinical pharmacology · 2021Review
- Improvements in Quality of Life and Thyroid Parameters in Hypothyroid Patients on Ethanol-Free Formula of Liquid Levothyroxine Therapy in Comparison to Tablet LT4 Form: An Observational Study.Journal of clinical medicine · 2021Article
- The frequency of HLA-DQ2/DQ8 haplotypes and celiac disease among the first-degree relatives of patients with celiac disease.Gastroenterology and hepatology from bed to bench · 2021Article
- Levothyroxine Therapy in Gastric Malabsorptive Disorders.Frontiers in endocrinology · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIn patients with hypothyroidism, levothyroxine (LT4) is the treatment of choice, and tablets are the most commonly prescribed formulation. Despite multiple scenarios being reported in the literature with impaired tablet absorption and likely missed TSH targets, it is yet unclear what the implications are for clinical practice and the role of liquid solution (LS) and soft gel (SG) formulations. We have thus conducted a narrative review evaluating the prevalence within the general population of gastrointestinal disorders impacting tablet LT4 absorption.
methodsPubMed and Google Scholar were searched until December 2019 for systematic reviews and meta-analyses on the topic. If they could not be retrieved, other types of manuscripts were searched.
resultsLactose malabsorption and Helicobacter pylori infection represented the most common disorders, with a global prevalence of 68% and 48%, respectively. The prevalence of other conditions, including autoimmune gastritis, bariatric surgery, celiac disease, gastroparesis, giardiasis, liver cirrhosis, or ulcerative colitis, was lower than 20%. Data at regional and country levels were found to be heterogeneous, but at least one in five patients was diagnosed with one disorder.
conclusionsThe worldwide prevalence of gastrointestinal disorders associated with tablet LT4 malabsorption, including lactose malabsorption and Helicobacter pylori infection, is high. Interactions with drugs or food can further increase this risk. Considering that all studies investigating the impact of switching patients from tablet to LS or SG found an improved thyroid balance, the latter formulations should be considered as first-line therapy for managing hypothyroidism.
Indexed as
Identifiers
31953721What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.