Lactose intolerance and levothyroxine malabsorption: a review of the literature and report of a series of patients treated with liquid L-T4 without lactose.

In hypothyroid patients needing large doses of levothyroxine (L-T4) (>1.7-2 µg/kg/day) to reach euthyroidism, lactose intolerance (LI) needs to be excluded, owing to the high prevalence in the population. If LI is present, a lactose-free diet decreases the rate of L-T4 malabsorption. However, an increased requirement of L-T4 is described in patients with LI, which can be beneficially treated using lactose-free L-T4 formulation. The lactose-free liquid L-T4 formulation is able to circumvent LI malabsorption leading to the normalization of thyroid-stimulating hormone (TSH) in patients with subclinical hypothyroidism and long-term stable TSH levels.

Exploring the Physiological Multiplicity of Native Microalgae from the Ecuadorian Highland, Italian Lowland and Indoor Locations in Response to UV-B.

The differential effects of UV-B on the inhibition or activation of protective mechanisms to maintain cells photosynthetically active were investigated in native microalgae. Four strains were used, including two Chlorella sorokiniana strains, F4 and LG1, isolated from a Mediterranean inland swamp and a recycled cigarette butt's substrate, respectively, and two isolates from an Ecuadorian highland lake related to Pectinodesmus pectinatus (PEC) and Ettlia pseudoalveolaris (ETI). Monocultures were exposed to acute UV-B (1.7 W m-2) over 18 h under controlled conditions. UV-B-untreated microalgae were used as the control. Comparative physiological responses, including photosynthetic pigments, non-enzymatic antioxidants, and chlorophyll a fluorescence, were evaluated at specific time points. Results showed that UV-B significantly compromised all the physiological parameters in F4, thereby resulting in the most UV-B-sensitive strain. Contrarily, UV-B exposure did not lead to changes in the PEC physiological traits, resulting in the best UV-B-resistant strain. This could be attributed to the acclimation to high light habitat, where maintaining a constitutive phenotype (at the photosynthetic level) is strategically advantageous. Differently, LG1 and ETI at 12 h of UV-B exposure showed different UV-B responses, which is probably related to acclimation, where in LG1, the pigments were recovered, and the antioxidants were still functioning, while in ETI, the accumulation of pigments and antioxidants was increased to avoid further photodamage. Consequently, the prolonged exposure in LG1 and ETI resulted in species-specific metabolic regulation (e.g., non-enzymatic antioxidants) in order to constrain full photoinhibition under acute UV-B.