Home|Journals|Articles by Year|Audio Abstracts
 

Review Article

IJMDC. 2020; 4(6): 1022-1027


Alternative levothyroxine administrating time: a systematic review

Ibarhim Mahmoud Ajwah, Badr Mohammed Alsharif, Abdullah Noman Alatawi, Yousef Musallam Albalawi, Othman Musad Albalawi, Assem Hammad Altemani, Kholoud Abdullah Aljohani, Shelian Juweed Alnomsi, Kholud Eid Albalawi, Elhassan Asia A, Marwa Mamoun Suliman, Hyder Osman Marghani.




Abstract

Studies justify prescribing levothyroxine (LT4) as the first-line treatment for patients with hypothyroidism. However, the strict administration requirements, since LT4 optimally absorbed during fasting state which mandates delaying of any food for at least 30 minutes. Consequently, the compliance with these instructions may be problematic for the patient's adherence. Therefore, we aimed to systematically assess the effects of bedtime LT4 administration on the degree of hypothyroidism clinical parameters. Several databases were systematically searched for relevant papers on alternative Levothyroxine administrating time. The papers published in the English language from the first available article up to March 2020 were approached. The terms hypothyroidism, LT4, and bed-time were used. Out of 316 papers retrieved, only seven fulfilled the inclusion and exclusion criteria. In the current review, seven full texts fulfilled the inclusion and exclusion criteria, of the two, showed a reduction in thyroid stimulating hormone (TSH) when thyroxine was administered at bedtime. Three studies showed that the bed-time administration is as effective as standard morning time administration. The last two studies examine the possibility of LT4 co-administration with meals and both show statistically significant higher TSH seen with non-fasting regimens. The review concluded that the medication adherence will be affected by the patient's preference. Therefore, if Levothyroxine administrating (30-60 minutes) before breakfast is not convenient, alternative regiment, such as bed-time or co-administration with the meal, may also be an option.

Key words: Bedtime, hypothyroidism, levothyroxine, review.






Full-text options


Share this Article


Online Article Submission
• ejmanager.com




ejPort - eJManager.com
Refer & Earn
JournalList
About BiblioMed
License Information
Terms & Conditions
Privacy Policy
Contact Us

The articles in Bibliomed are open access articles licensed under Creative Commons Attribution 4.0 International License (CC BY), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.