Thyroid Hormone Profile in Patients Ingesting Soft Gel Capsule or Liquid Levothyroxine Formulations with Breakfast.
Background. Recently, it has been shown that liquid L-T4 formulation can be ingested with breakfast. This study looked to extend these findings by investigating whether a soft gel capsule formulation of L-T4 could also be ingested at breakfast time. Methods. 60 patients (18-65 yrs), previously submitted to thyroidectomy for proven benign goitre in stable euthyroidism receiving liquid L-T4 therapy ingested with breakfast, were enrolled. TSH, fT4, and fT3 levels were assessed in all the patients who were switched from liquid L-T4 to a soft gel capsule formulation at the same dosage of L-T4. After 6 months, TSH, fT4, and fT3 levels were determined again. Results. There were no differences in TSH levels, but fT3 and fT4 levels during treatment with the soft gel capsule were significantly lower than those at enrolment with the liquid L-T4 formulation (TSH median (min-max): 1.9 (0.5-4.0) versus 2.2 (0.5-4.5) mIU/L, fT3: 2.5 (2.4-3.1) versus 2.7 (2.4-3.3) pg/mL, p < 0.05, and fT4: 9.9 (8.0-13) versus 10.6 (8.6-13.8) pg/mL, p < 0.0001). Conclusion. Both liquid and soft gel formulations of L-T4 can be taken with breakfast. However, liquid L-T4 would be the preferred formulation for patients in whom even small changes in fT4 and fT3 levels are to be avoided.
Department of Medical and Surgical Sciences, Endocrine and Metabolic Unit, Clinica Medica, 2nd Medicina, University of Brescia, Spedali Civili di Brescia, 25123 Brescia, Italy.
Carlo
C
Cappelli
Department of Medical and Surgical Sciences, Endocrine and Metabolic Unit, Clinica Medica, 2nd Medicina, University of Brescia, Spedali Civili di Brescia, 25123 Brescia, Italy.
Ilenia
I
Pirola
Department of Medical and Surgical Sciences, Endocrine and Metabolic Unit, Clinica Medica, 2nd Medicina, University of Brescia, Spedali Civili di Brescia, 25123 Brescia, Italy.
Elena
E
Gandossi
Department of Medical and Surgical Sciences, Endocrine and Metabolic Unit, Clinica Medica, 2nd Medicina, University of Brescia, Spedali Civili di Brescia, 25123 Brescia, Italy.
Alessandra
A
Cristiano
Department of Medical and Surgical Sciences, Endocrine and Metabolic Unit, Clinica Medica, 2nd Medicina, University of Brescia, Spedali Civili di Brescia, 25123 Brescia, Italy.
Linda
L
Daffini
Department of Medical and Surgical Sciences, Endocrine and Metabolic Unit, Clinica Medica, 2nd Medicina, University of Brescia, Spedali Civili di Brescia, 25123 Brescia, Italy.
Barbara
B
Agosti
Department of Molecular and Translational Medicine, 3rd Division of General Surgery, University of Brescia, Spedali Civili di Brescia, 25123 Brescia, Italy.
Claudio
C
Casella
Department of Medical and Surgical Sciences, Endocrine and Metabolic Unit, Clinica Medica, 2nd Medicina, University of Brescia, Spedali Civili di Brescia, 25123 Brescia, Italy.
Maurizio
M
Castellano