Abstract
We report the case of a young woman affected by hypothyroidism due to Hashimoto’s thyroiditis, previously well compensated with a full replacement therapy (150 mcg/day of levothyroxine), presenting a clinical picture of myxedema, with a TSH=650 mU/L. Two years earlier she had started a dialysis treatment because of a chronic renal failure and had been under treatment for the last 18 months with sevelamer carbonate, a phosphate binder. No improvement of clinical conditions nor reduction in TSH serum levels was observed even on increasing the dose of levothyroxine up to 300 mcg/day, whereas euthyroidism finally restored by administering the first morning dose of sevelamer carbonate at least 4 hours after levothyroxine administration. This case shows that sevelamer carbonate, in analogy with what has been already reported for sevelamer hydrochloride, can interfere with levothyroxine absorption leading to a condition of hypothyroidism in patients previously well compensated with a given replacement dose.
Keywords: Dialysis, hyperphosphataemia, hypothyroidism, intestinal absorption, levothyroxine, phosphate binder, sevelamer carbonate.
Endocrine, Metabolic & Immune Disorders - Drug Targets
Title:Sevelamer Carbonate Markedly Reduces Levothyroxine Absorption
Volume: 14 Issue: 3
Author(s): Michele Iovino, Nicola Iovine, Alfanso Petrosino, Vito A. Giagulli, Brunella Licchelli, Edoardo Guastamacchia and Vincenzo Triggiani
Affiliation:
Keywords: Dialysis, hyperphosphataemia, hypothyroidism, intestinal absorption, levothyroxine, phosphate binder, sevelamer carbonate.
Abstract: We report the case of a young woman affected by hypothyroidism due to Hashimoto’s thyroiditis, previously well compensated with a full replacement therapy (150 mcg/day of levothyroxine), presenting a clinical picture of myxedema, with a TSH=650 mU/L. Two years earlier she had started a dialysis treatment because of a chronic renal failure and had been under treatment for the last 18 months with sevelamer carbonate, a phosphate binder. No improvement of clinical conditions nor reduction in TSH serum levels was observed even on increasing the dose of levothyroxine up to 300 mcg/day, whereas euthyroidism finally restored by administering the first morning dose of sevelamer carbonate at least 4 hours after levothyroxine administration. This case shows that sevelamer carbonate, in analogy with what has been already reported for sevelamer hydrochloride, can interfere with levothyroxine absorption leading to a condition of hypothyroidism in patients previously well compensated with a given replacement dose.
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Iovino Michele, Iovine Nicola, Petrosino Alfanso, Giagulli A. Vito, Licchelli Brunella, Guastamacchia Edoardo and Triggiani Vincenzo, Sevelamer Carbonate Markedly Reduces Levothyroxine Absorption, Endocrine, Metabolic & Immune Disorders - Drug Targets 2014; 14 (3) . https://dx.doi.org/10.2174/1871530314666140902151804
DOI https://dx.doi.org/10.2174/1871530314666140902151804 |
Print ISSN 1871-5303 |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-3873 |
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