title: When thyroid hormone replacement is ineffective?
abstract: OBJECTIVE
  In this article, we will consider the failure of thyroid hormone replacement therapy to normalize serum thyroid stimulating hormone concentrations. We will review circumstances and causes for failures, discuss pertinent unpublished personal cases of didactical value, and provide practical suggestions for providers encountering patients with similar presentations.
  
  
  RESULTS
  Recent data are available on the benefit of novel formulations of levothyroxine therapy on malabsorption.
  
  
  CONCLUSIONS
  Most frequently, reasons for ineffectiveness are noncompliance, inappropriate administration of levothyroxine, gastrointestinal disorders, and drug interactions. The diagnostic work-up should include careful history to elucidate the potential reasons for the ineffective therapy.
authors: Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy. s.benvenga@me.nettuno.it
authors: Salvatore
authors: S
authors: Benvenga
mesh_terms: D050110:Bariatric Surgery / Q000009:adverse effects; D002626:Chemistry, Pharmaceutical; D004066:Digestive System Diseases / Q000150:complications; D023381:Endpoint Determination; D020249:Hormone Replacement Therapy; D006801:Humans; D007037:Hypothyroidism / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D010349:Patient Compliance; D013963:Thyroid Hormones / Q000627:therapeutic use*; D017211:Treatment Failure
chemical_list: D013963:Thyroid Hormones