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In thyroxine-replaced hypothyroid postmenopausal women under simultaneous calcium supplementation, switch to oral liquid or softgel capsule l-thyroxine ensures lower serum TSH levels and favorable effects on blood pressure, total cholesterolemia and glycemia

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A Correction to this article was published on 28 June 2019

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Abstract

Purpose

In postmenopausal women under L-T4 therapy, which was subsequently accompanied by calcium carbonate (CC) supplementation taken 6–8 h after tablet L-T4, TSH levels were greater than prior to adding CC. Total cholesterolemia [CHOL], fasting glycemia [FG], systolic and diastolic blood pressure [SBP, DBP] were also greater than baseline. Our aim was to explore the effects of either liquid or softgel capsule L-T4, while maintaining CC ingestion 6–8 h, later on TSH levels, CHOL, FG, SBP, and DBP.

Methods

We proposed to 50 hypothyroid postmenopausal women under tablet L-T4 therapy, to switch to either liquid or softgel capsule L-T4 at the same daily dose while maintaining CC ingestion 6–8 h later. Sixteen women accepted [group I; liquid (n = 9), capsule (n = 7)], while 34 continued tablet L-T4 [group II, (n = 34)].

Results

After 3 months, in group I, TSH decreased significantly (1.23 ± 0.49 vs. 1.80 ± 0.37 mU/L, P < 0.01), as did FG (80.7 ± 7.9 vs. 83.4 ± 6.3 mg/dL, P < 0.05); CHOL, SBP, and DBP decreased, though insignificantly. In contrast, in group II, TSH, FG, CHOL, SBP increased insignificantly, and DBP increased borderline significantly (69.7 ± 9 vs. 66.3 ± 6.5, P < 0.10). Compared to baseline (before adding CC), in group I, TSH was significantly lower (P < 0.01) and the other indices similar; in group II, TSH, FG, and SBP were significantly higher (P < 0.05), DBP borderline significantly higher (P < 0.10) and CHOL insignificantly higher. Performance of liquid L-T4 and capsule L-T4 was similar.

Conclusion

Delaying CC ingestion even by 6–8 h after taking tablet L-T4 is not entirely satisfactory, unlike liquid or softgel L-T4.

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Change history

  • 28 June 2019

    An amendment to this paper has been published and can be accessed via a link at the top of the paper.

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, University of Messina, Building H, 4th floor, via C. Valeria, Messina, 98125, Italy

    Elisabetta Morini, Antonino Catalano, Antonino Lasco, Nunziata Morabito & Salvatore Benvenga

  2. Master Program on Childhood, Adolescent and Women’s Endocrine Health, University of Messina, Messina, 98125, Italy

    Salvatore Benvenga

  3. Interdepartmental Program of Molecular & Clinical Endocrinology, and Women’s Endocrine Health, University Hospital Policlinico G. Martino, via Consolare Valeria, Messina, 98125, Italy

    Salvatore Benvenga

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Correspondence to Salvatore Benvenga.

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Conflict of interest

S.B. received novel formulations of LT4 from IBSA Institute Biochimique (Lugano, Switzerland) and IBSA s.r.l. (Lodi, Italy) to be given to patients for conducting clinical studies. In addition, S.B. was an invited speaker at symposia organized by IBSA. However, IBSA had no role in any phase of the writing of this manuscript. The remaining authors declare that they have no conflict of interest.

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

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Morini, E., Catalano, A., Lasco, A. et al. In thyroxine-replaced hypothyroid postmenopausal women under simultaneous calcium supplementation, switch to oral liquid or softgel capsule l-thyroxine ensures lower serum TSH levels and favorable effects on blood pressure, total cholesterolemia and glycemia. Endocrine 65, 569–579 (2019). https://doi.org/10.1007/s12020-019-01908-x

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