About this Research Topic
The aim of this Research Topic is to investigate the use of the Levothyroxine (L-T4) therapy in different subjects, from children to the elderly, from pregnant women to thyroidectomized patients. We would like also to focus attention on the new L-T4 formulations, particularly on their use and their pharmacokinetic.
Levothyroxine is used worldwide for the treatment of hypothyroidism, traditionally in tablet form. Unfortunately, several issues often arise in the management of patients that are not able to absorb this drug, often leading physicians to increase their L-T4 daily dose. Malabsorption issues can be related to several factors: 1) gastric, or enteric disorders of autoimmune origins (such as celiac disease, autoimmune atrophic gastritis); 2) bariatric surgery; 3) interfering factors, such as the concomitant use of other drugs (such as proton-pump inhibitors); 4) food and beverages (such as coffee and fiber); 5) improper habits in the ingestion of the drug. Most of the malabsorption issues are related to L-T4 tablet formulations. Therefore, new L-T4 formulations were made to overcome these issues, such as the liquid preparation and the soft gel capsule.
Different studies demonstrate that the new formulations yield better results in the management of hypothyroid or thyroidectomized patients, with or without malabsorption or drug interference issues.
Further studies are needed to better understand this clinical topic, which will be useful for better management of the patients and for their well-being.
Declaration of Conflict of Interest:
Prof. Alessandro Antonelli has no personal competing interest with pharmaceutical companies that produce or commercialize drugs containing Levothyroxine. His Department of Clinical and Experimental Medicine of the University of Pisa, received a grant from IBSA for basic researches on the iodothyronine T2 and also have received support for the participation at Congresses. He is the principal investigator in the department for the study of the therapeutic use of Teprotumumab in patients with Graves' Opthalmopathy.
Prof. Paolo Miccoli has no personal competing interest with pharmaceutical companies that produce or commercialize drugs containing Levothyroxine. He is the President of the AREA Foundation that received grants from IBSA and also he has received support for the participation at Congresses
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