Systematic appraisal of lactose intolerance as cause of increased need for oral thyroxine.
J Clin Endocrinol Metab
; 99(8): E1454-8, 2014 Aug.
Article
in En
| MEDLINE
| ID: mdl-24796930
ABSTRACT
CONTEXT An increased need for T4 has been described in patients with different gastrointestinal disorders. However, there is a lack of systematic studies assessing the need for T4 in hypothyroid patients with lactose intolerance, a widespread and often occult disorder. OBJECTIVE:
The objective of the study was to assess the replacement T4 dose required in hypothyroid patients with lactose intolerance.DESIGN:
This was a cohort study.SETTING:
The study was conducted at an outpatient endocrinology unit in a University Hospital. PATIENTS The replacement T4 dose has been analyzed, from 2009 to 2012, in 34 hypothyroid patients due to Hashimoto's thyroiditis and lactose intolerance and being noncompliant with a lactose-free diet. MAIN OUTCOMEMEASURE:
An individually tailored T4 dose was measured.RESULTS:
In all patients with isolated Hashimoto's thyroiditis, target TSH (median TSH 1.02 mU/L) was obtained at a median T4 dose of 1.31 µg/kg/d. In patients with lactose intolerance, only five of 34 patients reached the desired TSH (median TSH 0.83 mU/L) with a similar T4 dose (1.29 µg/kg/d). In the remaining 29 patients, the T4 dose was progressively increased and the target TSH (median TSH 1.21 mU/L) was attained at a median T4 dose of 1.81 µg/kg/d (+38%, P < .0001). In six of these patients, other gastrointestinal disorders were diagnosed, and their median T4 requirement was higher (2.04 µg/kg/d; +55%; P = .0032). In the remaining 23 patients with isolated lactose intolerance, a median T4 dose of 1.72 µg/kg/d (+31% P < .0001) has been required to attain pharmacological thyroid homeostasis.CONCLUSIONS:
These findings show that lactose intolerance significantly increased the need for oral T4 in hypothyroid patients.
Full text:
1
Database:
MEDLINE
Main subject:
Thyroxine
/
Hypothyroidism
/
Lactose Intolerance
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Year:
2014
Type:
Article