Severe hypothyroidism in patients dependent on prolonged thyroxine infusion through a jejunostomy

Smyrniotis, Vasilios; Vaos, N.; Arkadopoulos, N.; Kostopanagiotou, Georgia; Theodoraki, Kassiani; Lambrou, A.

doi:10.1054/clnu.1999.0087

Cited by 8 publications

(5 citation statements)

References 10 publications

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“… 34 , 35 Levothyroxine's absorption is markedly reduced when administered via a jejunostomy or when given to those with malabsorption syndromes. 36 , 37 Levothyroxine is most commonly administered after an overnight fast and 30‐60 minutes prior to breakfast as an approximate 15% decrease in absorption occurs when coadministered with food 3 …”

Section: Resultsmentioning

confidence: 99%

Clinical Relevancy of the Levothyroxine–Continuous Enteral Nutrition Interaction

et al. 2010

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Section: Resultsmentioning

confidence: 99%

Clinical Relevancy of the Levothyroxine–Continuous Enteral Nutrition Interaction

et al. 2010

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“…One report in the literature case also described 2 patients who developed hypothyroidism during prolonged LT4 administration via a jejunostomy tube after esophagopharyngeal resection. 13 These patients, however, were not hypothyroid prior to surgery; therefore, the effect of enteral feeds on the bioavailability of levothyroxine in these patients could not be observed.…”

Section: Quantifying Amount Of Adsorption Of Levothyroxine By Percutamentioning

confidence: 89%

Quantifying Amount of Adsorption of Levothyroxine by Percutaneous Endoscopic Gastrostomy Tubes

Manessis

Lascher

Bukberg

et al. 2008

J Parenter Enteral Nutr

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“…LT4 malabsorption can also be induced by intestinal surgery and diseases. Since ∼70% of oral LT4 is absorbed in the duodenum, jejunum, and ileum, jejunostomy and bowel resection lead to a substantial decrease in drug absorption ( 52 ). Some patients with short bowel syndrome were reported to be refractory to oral LT4, and alternative routes, such as rectal administration or SC injection, were recommended ( 24 , 53 ).…”

Section: Impaired Bioavailability and Malabsorption Of Oral Lt4 Tabletsmentioning

confidence: 99%

Levothyroxine: Conventional and Novel Drug Delivery Formulations

Liu

Zhang

et al. 2022

Endocrine Reviews

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Despite the fact that levothyroxine is one of the most prescribed medications in the world, its bioavailability has been reported to be impaired by many factors, including interfering drugs or foods and concomitant diseases, and persistent hypothyroidism with a high dose of levothyroxine is thus elicited. Persistent hypothyroidism can also be induced by noninterchangeability between formulations and poor compliance. To address these issues, some strategies have been developed. Novel formulations (liquid solutions and soft-gel capsules) have been designed to eliminate malabsorption. Some other delivery routes (injections, suppositories, sprays, and sublingual and transdermal administrations) are aimed at circumventing different difficulties in dosing, such as thyroid emergencies and dysphagia. Moreover, nanomaterials have been used to develop delivery systems for the sustained release of levothyroxine to improve patient compliance and reduce costs. Some delivery systems encapsulating nanoparticles show promising release profiles. In this review, we first summarize the medical conditions that interfere with the bioavailability of oral levothyroxine and discuss the underlying mechanisms and treatments. The efficacy of liquid solutions and soft-gel capsules are systematically evaluated. We further summarize the novel delivery routes for levothyroxine and their possible applications. Nanomaterials in the levothyroxine field are then discussed and compared based on their load and release profile. We hope the article provides novel insights into the drug delivery of levothyroxine.

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Severe hypothyroidism in patients dependent on prolonged thyroxine infusion through a jejunostomy

Cited by 8 publications

References 10 publications

Clinical Relevancy of the Levothyroxine–Continuous Enteral Nutrition Interaction

Clinical Relevancy of the Levothyroxine–Continuous Enteral Nutrition Interaction

Quantifying Amount of Adsorption of Levothyroxine by Percutaneous Endoscopic Gastrostomy Tubes

Levothyroxine: Conventional and Novel Drug Delivery Formulations

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