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 Outcome Measure: 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 (1.29μg/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. Copyright © 2014 by the Endocrine Society.

Systematic appraisal of lactose intolerance as cause of increased need for oral thyroxine / Cellini, Miriam; Santaguida, Maria Giulia; Gatto, Ilenia; Virili, Camilla; Del Duca, Susanna Carlotta; Brusca, Nunzia; Capriello, Silvia; Gargano, Lucilla; Centanni, Marco. - In: THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM. - ISSN 0021-972X. - ELETTRONICO. - 99:8(2014), pp. E1454-E1458. [10.1210/jc.2014-1217]

Systematic appraisal of lactose intolerance as cause of increased need for oral thyroxine

Miriam, Cellini;Maria, Giulia Santaguida;Ilenia, Gatto;Camilla, Virili;Susanna, Carlotta Del Duca;Nunzia, Brusca;Silvia, Capriello;Marco, Centanni
2014

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 Outcome Measure: 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 (1.29μg/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. Copyright © 2014 by the Endocrine Society.
2014
hypothyroidism; lactose; thyroxine
01 Pubblicazione su rivista::01l Trial clinico
Systematic appraisal of lactose intolerance as cause of increased need for oral thyroxine / Cellini, Miriam; Santaguida, Maria Giulia; Gatto, Ilenia; Virili, Camilla; Del Duca, Susanna Carlotta; Brusca, Nunzia; Capriello, Silvia; Gargano, Lucilla; Centanni, Marco. - In: THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM. - ISSN 0021-972X. - ELETTRONICO. - 99:8(2014), pp. E1454-E1458. [10.1210/jc.2014-1217]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/560972
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