, Volume 57, Issue 1, pp 175–178 | Cite as

Patients with lactose intolerance absorb liquid levothyroxine better than tablet levothyroxine

  • Poupak Fallahi
  • Silvia Martina Ferrari
  • Santino Marchi
  • Nicola De Bortoli
  • Ilaria Ruffilli
  • Alessandro AntonelliEmail author
Research Letter


The need to use high L-thyroxine (L-T4) doses in the replacement treatment of hypothyroidism is often the very first sign of one of the pathologies that are connected with malabsorption syndrome [1, 2, 3, 4, 5, 6]. Also lactose intolerance (LI) should be considered in the differential diagnosis of gastrointestinal diseases that can cause malabsorption of L-T4 [3]. The prevalence of LI in Caucasian adult patients ranges 7–20 %, but its occurrence may be frequently ignored [3]. In the case of a diagnosis of LI, both a low lactose diet, and a lactose-free L-T4 preparation, should be administered to restore euthyroidism or make it possible to decrease the dose of the L-T4 [7].

Here we report our experience, in 5 patients with LI with an increase in serum thyrotropin [thyroid stimulating hormone (TSH)] levels, while receiving ‘L-T4 in tablet form containing lactose’ (L-T4-Tab+Lactose), that was reversibly resolved by switching to the same dose in a ‘liquid (Tirosint®vial,...


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in this study.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Poupak Fallahi
    • 1
  • Silvia Martina Ferrari
    • 1
  • Santino Marchi
    • 2
  • Nicola De Bortoli
    • 2
  • Ilaria Ruffilli
    • 1
  • Alessandro Antonelli
    • 1
    Email author
  1. 1.Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
  2. 2.Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly

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